Tetralogy of Fallot: Difference between revisions

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===[[Tetralogy of fallot differential diagnosis |Tetralogy of fallot differential diagnosis]]===
===[[Tetralogy of fallot differential diagnosis |Tetralogy of fallot differential diagnosis]]===


===Tetralogy of fallot diagnosis===
===[[Tetralogy of fallot diagnosis|Tetralogy of fallot diagnosis]]===


===[[Tetralogy of fallot history and symptoms|Tetralogy of fallot history and symptoms]]===
===[[Tetralogy of fallot history and symptoms|Tetralogy of fallot history and symptoms]]===
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===[[Tetralogy of fallot physical examination|Tetralogy of fallot physical examination]]===
===[[Tetralogy of fallot physical examination|Tetralogy of fallot physical examination]]===


===Tetralogy of fallot lab studies===
===[[Tetralogy of fallot lab studies|Tetralogy of fallot lab studies]]===


===[[Tetralogy of fallot electrocardiogram|Tetralogy of fallot electrocardiogram]]===
===[[Tetralogy of fallot electrocardiogram|Tetralogy of fallot electrocardiogram]]===
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===[[Tetralogy of fallot cardiac catheterization|Tetralogy of fallot cardiac catheterization ]]===
===[[Tetralogy of fallot cardiac catheterization|Tetralogy of fallot cardiac catheterization ]]===
===[[Tetralogy of fallot other tests|Tetralogy of fallot other tests ]]===


===[[Tetralogy of fallot treatment |Tetralogy of fallot treatment]]===
===[[Tetralogy of fallot treatment |Tetralogy of fallot treatment]]===
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[[Tetralogy of fallot prevention |Tetralogy of fallot prevention]]
[[Tetralogy of fallot prevention |Tetralogy of fallot prevention]]
==References==
{{reflist|2}}
== External Links for VSD ==
* [http://www.pediatricheartsurgery.com Pediatric Heart Surgery]
* [http://www.youtube.com/user/Redmond111 The Congenital Heart Surgery Video Project]
* [http://www.youtube.com/watch?v=Uf_tRlG1nMc VSD Repair, Perimembranous Ventricular Septal Defect]
* [http://www.scribd.com/doc/5563960/VSD-Ventricular-Septal-Defect-Repair VSD Repair Powerpoint™ Presentation]
==Acknowledgements and Initial Contributors to Page==
Leida Perez, M.D.
Redmond Burke M.D.
==References==
{{Reflist|2}}
{{Congenital malformations and deformations of circulatory system}}
{{SIB}}
[[de:Herzfehler]]
[[es:Cardiopatía congénita]]
[[fr:Cardiopathie congénitale]]
[[lv:Iedzimtās sirds slimības]]
[[nn:Medfødd hjartefeil]]
[[pl:Wada serca]]
[[pt:Cardiopatia congênita]]
[[sr:Урођене срчане мане]]
[[uk:Вроджені вади серця]]
[[wa:Maladeye des bleus påpåds]]
[[tr:Doğumsal kalp hastalıkları]]
[[Category:Cardiology]]
[[Category:Congenital heart disease]]
[[Category:Genetic Disease]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
#Arterial oxygen desaturation is evident, as is compensatory erythrocytosis, the magnitude of which is proportional to the severity of the desaturation.
==Treatment==
Tetralogy of Fallot is treated on two levels: with immediate emergency care for hypoxic or "tet" spells and with corrective surgery.
===Emergency management of tet spells===
Consequential acute hypoxia may be treated with [[beta-blockers]] such as [[propranolol]], but acute episodes may require rapid intervention with [[morphine]] to reduce ventilatory drive and [[phenylephrine]] to increase blood pressure. Oxygen is ineffective in treating hypoxic spells because the underlying problem is lack of blood flow through the pulmonary circuit and not alveolar oxygenation.  There are also simple procedures such as the knee-chest position which increases aortic wave reflection, increasing pressure on the left side of the heart, decreasing the right to left shunt thus decreasing the amount of deoxygenated blood entering the systemic circulation.<ref>{{cite journal |author=Murakami T |title=Squatting: the hemodynamic change is induced by enhanced aortic wave reflection |journal=Am. J. Hypertens. |volume=15 |issue=11 |pages=986-8 |year=2002 |pmid=12441219}}</ref>
===Palliative surgery===
The condition was initially thought untreatable until surgeon [[Alfred Blalock]], cardiologist [[Helen B. Taussig]], and lab assistant [[Vivien Thomas]] at Johns Hopkins University developed a surgical procedure, which involved forming an anastomosis between the subclavian artery and the pulmonary artery. It was actually Helen Taussig who convinced Alfred Blalock that the shunt was going to work. This redirected a large portion of the partially oxygenated blood leaving the heart for the body into the lungs, increasing flow through the pulmonary circuit, and greatly relieving symptoms in patients. The first [[Blalock-Thomas-Taussig shunt]] surgery was performed on 15-month old Eileen Saxon on November 29, 1944 with dramatic results.
The Pott shunt and the Waterson procedure are other shunt procedures which were developed for the same purpose.
Currently, Blalock-Thomas-Taussig shunts are not normally performed on infants with TOF except for severe variants such as TOF with pulmonary atresia.
===Total surgical repair===
The Blalock-Taussig procedure was the only surgical treatment until the first total repair was performed in 1954.  Between 1944 and when total repair became available at major surgical centers in the early 1960s, many infants and children were treated with Blalock-Taussig procedures.
The total repair was performed by [[C. Walton Lillehei]] at the University of Minnesota in 1954 on a 10-month boy.  Total repair initially carried a high mortality risk which has consistently improved over the years. Surgery is now often carried out in infants 1 year of age or younger with a <5% perioperative mortality. The surgery generally involves making incisions into the heart muscle, relieving the right ventricular outflow tract stenosis by careful resection of muscle, and repairing the VSD using a Gore-Tex or Dacron patch or a homograft.  Additional reparative or reconstructive work may be done on patients as required by their particular anatomy.
Patients who have undergone "total" repair of tetralogy of Fallot often have good to excellent cardiac function after the operation with some to no exercise intolerance and have the potential to lead normal lives.  Surgical success and long-term outcome greatly depends on the particular anatomy of the patient and the surgeon's skill and experience with this type of repair.




Revision as of 15:07, 13 July 2011

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Tetralogy of fallot Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editors-In-Chief: Keri Shafer, M.D. [2]; Atif Mohammad, M.D., Priyamvada Singh, MBBS

Tetralogy of fallot diagram

Tetralogy of fallot overview

Tetralogy of fallot anatomy

Tetralogy of fallot pathophysiology

Tetralogy of fallot epidemiology and demographics

Tetralogy of fallot natural history, complications and prognosis

Tetralogy of fallot causes

Tetralogy of fallot differential diagnosis

Tetralogy of fallot diagnosis

Tetralogy of fallot history and symptoms

Tetralogy of fallot physical examination

Tetralogy of fallot lab studies

Tetralogy of fallot electrocardiogram

Tetralogy of fallot chest xray

Tetralogy of fallot echocardiography

Tetralogy of fallot cardiac catheterization

Tetralogy of fallot treatment

ACC/AHA guidelines tetralogy of fallot

Tetralogy of fallot surgical techniques

Tetralogy of fallot prognosis

Tetralogy of fallot prevention


See also

References

External links

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de:Fallot-Tetralogie it:Tetralogia di Fallot nl:Tetralogie van Fallot nn:Fallots tetrade uk:Тетрада Фалло


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