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Your Child's Tetralogy of Fallot Surgery 

Cross section of heart showing Tetralogy of Fallot.

Tetralogy of Fallot (TOF) is a common complex heart defect. TOF is a serious heart condition. But it can be repaired with surgery.

How do I prepare my child for tetralogy of Fallot surgery?

You’ll be told to keep your child from eating or drinking for a certain amount of time before surgery. Follow these instructions carefully.

What happens during tetralogy of Fallot surgery?

  • Your child is given medicine (sedative and anesthesia) to help him or her sleep and not feel pain during surgery.

  • A breathing tube is placed in your child’s trachea (windpipe). Special devices watch your child’s heart rate, blood pressure, and oxygen levels during this time.

  • An incision is made in the chest through the sternum (breastbone) to access the heart.

  • Your child is placed on a heart-lung bypass machine. This lets blood keep flowing to the body so the heart can be operated on.

  • The VSD is most often closed with a patch. Tissue that causes a blockage at or below the pulmonary valve is removed as needed. The pulmonary artery or the branch pulmonary arteries may be made larger with a patch.

  • Then, your child is taken off the bypass machine and the chest is usually closed.

What happens after tetralogy of Fallot surgery?

Your child is taken to an intensive care unit to be cared for and monitored. Your child will have several catheters, tubes, and wires attached to him or her right after surgery. These are in place to assist the intensive care team care for your child. You can stay with your child during much of this time. He or she may stay in the hospital for 5 to 10 days. When your child is ready to leave the hospital, you’ll be given instructions for home care. 

When to call the healthcare provider

Call the healthcare provider right away if your child has any of these:

  • Redness, fluid leaking, swelling, or bleeding at the incision site that gets worse

  • Fever 100.4°F (38°C) or higher

  • Trouble feeding

  • Tiredness

  • Shortness of breath or trouble breathing

  • Cough that won’t go away

  • Nausea or vomiting that continues

  • Irregular heartbeat

  • Swelling or fluid buildup in the arms or legs

  • Passing out or dizziness 

What are the long-term concerns?

Your child will need regular follow-up visits with a cardiologist for the rest of his or her life. More pulmonary valve treatment may be needed. This may include more surgery. Or it may include catheterization treatment. Your child may also develop heart rhythm problems. These may need to be treated.

After repair of TOF, most children can be active. The level and extent of physical activity will vary with each child. Check with the cardiologist about what activities are best for your child.

Your child may always need to take antibiotics before having any surgery or dental work. This is to prevent infection of the inside lining of the heart and valves. This is called bacterial endocarditis. Antibiotics should be taken exactly as directed.

Online Medical Reviewer: Lu Cunningham RN BSN
Online Medical Reviewer: Pat F Bass MD MPH
Online Medical Reviewer: Scott Aydin MD
Date Last Reviewed: 12/1/2019
© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.