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Tetralogy of Fallot
Tetralogy of Fallot is the most common cause of cyanotic congenital heart disease (ie. congenital heart disease with lower than normal oxygen levels). It was first described by Professor Arthur Fallot, a French physician who lived from 1850-1911.
Tetralogy of Fallot is repaired with an operation in early childhood, but the heart is not completely normal after this surgery and there are important things that we need to watch out for. People who have had this surgery need life long cardiology follow-up. Many people who had this surgery as a child will eventually need further surgery in adulthood to replace the pulmonary valve.
The boxes below describe three of the most important problems that we see in adults with Tetralogy of Fallot
For further information about Tetralogy of Fallot click on the links at the bottom of the page
Pulmonary
Regurgitation
It means that you have a leaky pulmonary valve (the valve controlling blood going out to the lungs from the heart).
It happens because this valve is usually too small in people with tetralogy of Fallot. The surgeons have to open the valve up when they do a tetralogy repair operation, but the trade-off of opening up the valve is that it becomes leaky.
Because of the leaky valve, some of the blood that your heart pumps out to your lungs now leaks back into your heart. This makes extra work for the right ventricle of your heart and the ventricle often becomes progressively enlarged. In time this can cause weakness of the right ventricle and other complications.
We can do an operation to implant a new valve. The valves don’t last for ever, so it’s important to get the timing right. We monitor you with tests like echo, MRI and exercise tests to help us work out if you need a replacement valve.
Click here to watch a video from the Uk about pulmonary valve replacement.
Usually not, but it is important that you let us know if you notice new symptoms as this can sometimes be a sign that you need a valve replacement.
Ventricular
Tachycardia
It’s an abnormal fast heart rhythm arising from the ventricles (the pumping chambers) of the heart.
It happens firstly because there is often scarring in the ventricles as a result of the previous heart surgery and secondly because the right ventricle is doing extra work in people who have had this surgery.
It can be a dangerous heart rhythm that means the heart cannot pump blood efficiently enough to supply blood to the body, particularly the brain. If it is bad it can cause loss of consciousness and in rare cases can even cause sudden death.
First up, we will often use heart rhythm medicines. Sometimes we will do a specialized heart catheter procedure to try to stop the abnormal rhythm from occurring. Some people will need an implantable defibrillator (ICD).
Not usually, although some people will notice that abnormal heart rhythms are made worse by things like excessive alcohol or caffeine.
Bacterial
Endocarditis
It’s an infection of the interior lining of the heart, often involving the heart valves
It happens when bacteria get into the bloodstream and settle out on the inside of the heart. It is more common in people who have had heart surgery, particularly if you have had a heart valve replacement.
It is a dangerous infection that is difficult to treat with antibiotics. It sometimes needs surgery and sometimes it can even be fatal.
Like any bacterial infection we use antibiotics. Endocarditis usually needs a long course of intravenous antibiotics and sometimes needs surgery to remove the infected valve if the antibiotics don’t successfully control the infection.
We know that the bacteria that cause endocarditis often originate from our mouths. Taking good care of your teeth and gums is really important – brushing, flossing and seeing the dentist regularly.
There is a separate section about endocarditis on this website. Click here if you want to find out more information about endocarditis.