Tetra (tet-ra) means four (4).  Tetralogy of Fallot has 4 defects:

	Pulmonary stenosis—a narrowing of the pulmonary artery and the pulmonary valve causing an obstruction (blockage) of blood flow out of the right ventricle to the lungs.
	Ventricular septal defect (VSD)—an opening or “hole” in the septum (wall) between the 2 lower chambers or compartments of the heart.  For more information on the VSD, see the document, Ventricular Septal Defect.  Please ask your nurse for a copy of it.
	Overriding aorta—the aorta’s valve is enlarged and connects both ventricles (right and left) instead of just the left ventricle as happens in the normal heart.
	Right ventricular hypertrophy (high-per-tra-fee)—a thickening or enlargement of the muscle wall of the right ventricle (one of the lower chambers or compartments of the heart.

Tetralogy of Fallot is one of the most common forms of cyanotic congenital heart defect.  Cyanotic or Cyanosis means a bluish coloring to the baby’s lips and skin.  Usually the cyanosis is not seen immediately after birth.  It usually develops or becomes more noticeable in the first few days of life, before your baby is discharged from the hospital.

 A Pediatric Cardiologist—a specialist in heart problems of babies and children—sees babies with TOF

If the neonatologist notices any of the symptoms listed above and thinks the baby has TOF, an echocardiogram may be ordered. 

Echocardiography (ECHO):  An ECHO is an ultrasound of the heart.  It is a painless procedure that uses high-frequency sound waves to look at the heart structures and to measure the blood flow through his heart.  This test will not hurt your baby and is done at your baby’s bedside.

The pediatric cardiologist will see your baby and will decide if your baby’s heart defect needs

	Regular checkups
	Special tests and procedures
	Surgery

Special tests and procedures

Cardiac catheterization:  Sometimes, but not usually, this procedure needs to be done.  A cardiac catheterization, often called a “cardiac cath,” can evaluate the size of the pulmonary artery, give us information about the pulmonary valve as well as information about the blood flow through the heart and lungs.  This procedure is done in the Cardiac Cath Department and the baby is asleep for this procedure.

If your baby does need a “cardiac cath” and/or surgery, he will be transferred to either Duke University Medical Center or The University Hospital at Chapel Hill for the procedure or surgery. 

	Sometimes, if you baby is doing well, the surgery can be delayed for several months while your baby grows.
	If the decision is to transfer your baby to another hospital you will be asked to sign a consent giving Cape Fear Valley Medical Center permission to transfer your baby.
	If your baby is transferred to another hospital, the doctors there will also talk with you about your baby’s surgery.

The surgery is done in the Operating Room and the baby is asleep for the surgery.  You will be asked to sign a consent (give permission) for the surgery.

Once your baby’s condition is stable and the doctors are happy with the baby’s progress, the baby will be returned to Cape Fear Valley Medical Center’s Neonatal Intensive Care Unit.

Both the pediatric cardiologist and our neonatologist will talk with you about your baby and what they recommend. 

Please feel free to ask questions at any time. 

An important part of the baby getting better is the parents’ love and concern.

We encourage you to talk and sing to your baby, gently touch or rub them and hold them close if tolerated by the baby.  Talk with your baby’s nurse about this. 

Your love and attention will go a long way in helping your little one on the road to recovery. 

Once your baby returns to Cape Fear Valley Medical Center, keep up with your baby’s progress each time you visit or call.