Tetralogy of Fallot Surgery Success Rate

Fallot’s tetralogy is a difficult and uncommon condition that can only be addressed by surgery. Cost of TOF surgery starts from USD 6,500 in India. Indian Heart surgeons have a 100% survival rate in Tetralogy of Fallot repair.

Tetralogy of Fallot

A congenital (present from birth) cardiac abnormality is usually corrected by tetralogy of Fallot surgery within the first year of life. A heart condition called tetralogy of Fallot consists of four connected heart abnormalities.

These flaws include right ventricular hypertrophy, pulmonary valve stenosis, aortic malposition, and ventricular septal defect.

Tetralogy of Fallot is a collection of heart abnormalities that often manifests within a few days of birth; however, it can occasionally go undiagnosed for a month or two. Even before birth, it might be found during a prenatal ultrasound. Tetralogy is a set of four things.

There are four components to the cardiac abnormalities in the tetralogy of Fallot. Which are:

Ventricular Septal Defect: A hole in the septum (wall) separating the lower chambers of the heart is known as a ventricular septal defect.

Pulmonary Stenosis: A completely blocked or narrowed pulmonary valve is known as pulmonary stenosis. This limits the heart’s ability to pump blood to the lungs.

Malposition Of The Aorta: The aorta is in an abnormal position because it is situated right above the ventricular septal defect. The aorta is entirely on the left side of a typical heart, but not in this case.

Right Ventricular Hypertrophy: The constricted pulmonary valve causes the right-sided pumping chamber to thicken.

Patient Testimonial: 6 years old kid from Nigeria came to India along with her mother for Tetralogy of Fallot surgery.

Mrs. Iyorokpemi Boumene Fabo shares her experience with Lyfboat during her stay in India for TOF repair surgery. She thanks Dr.Surbhi and Lyboat team for all their help and support.

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Effects of the Defect

The hole between the pumping chamber and the narrowed valve is the cause of the issues in the tetralogy of Fallot.

Ordinarily, blood is pumped from the right ventricle to the lungs and from the left ventricle to the body.

In the event of a tetralogy of Fallot, blood can flow from the right ventricle to the left ventricle, where it is pumped to the rest of the body, via the ventricular septal defect (hole). Because the blood on the right side has a low oxygen content, the blood inside the body won’t have as much oxygen as usual.

Blood flow to the lungs is also restricted by a narrowed or blocked (obstructed) pulmonary valve, resulting in lower-than-normal blood flow to the lungs.

Children and infants with tetralogy of Fallot may experience cyanosis, a bluish tinge to the skin. This occurs as a result of part of the low-oxygen blood being pumped into the body from the other side of the hole (VSD).

Tetralogy of Fallot, sometimes known as “Tet spells,” can occasionally cause severe blue spells in infants or young children. The newborn may have significant cyanosis (blueness) during a Tet episode, which frequently follows rapid, deep breathing, elevated irritability, and protracted wailing.

An emergency may arise from a Tet spell that does not improve after several minutes of efforts to quiet the infant and “break” the spell. If the Tet spell continues, immediate medical intervention is necessary.

Tetralogy of Fallot (TOF) Surgery Cost in India

Tetralogy of Fallot (TOF) is a rare disorder that can only be handled by a cardiac surgeon with extensive skill.

The procedure takes four to five hours to complete because there are four distinct problem locations or abnormalities in this congenital condition.

Surgery for TOF in India is more expensive than the majority of other cardiology surgical operations due to the complexity of the treatment process and the sensitivity of the ailment. The surgeon moves from one problem to the next in a row as he corrects the defects step by step.

TOF surgery cost in India is estimated to be around $6500. This is just a fraction of what the same surgery costs in the US. The TOF surgery cost in the US is estimated to be around $50000.

The cost of Fallot’s tetralogy treatment in India depends on several factors. Some of the major factors that determine Fallot’s tetralogy treatment cost in India include the following:

  • Choice of hospital
  • Choice of city
  • Condition of the patient
  • Side procedures required or not
  • Number of diagnostic tests conducted
  • Number of days spent in hospital
  • Critical care required or not
  • Surgeon’s fees
  • Hospital fees
  • Occurrence of complications

Despite all these factors that control the cost of TOF surgery in India, the total amount remains less than what the same procedure costs in any other country in the world, including the US, the UK, Malaysia, Russia, and Canada.

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The Four TOF Defects

Ventricular Septal Defect

A septum divides the right and left chambers of the heart from one another. A hole in the septum that separates the ventricles, the two bottom chambers of the heart, is known as a ventricular septal defect. Blood that has been oxygenated and blood that has been deoxygenated combine as a result.

Pulmonary Stenosis

Pulmonary stenosis is characterised by the narrowing of the pulmonary valve. So, in order to properly pump blood to the lungs, the heart must beat more rapidly and vigorously.

Right Ventricular Hypertrophy

Right ventricle thickening is a defining feature of this illness. Due to pulmonary stenosis, the heart must pump more quickly than necessary to provide the lungs with blood.

Overriding Aorta

The aorta is misplaced in this disorder, which is one of its defining features. The aorta typically connects to the left ventricle. The aorta is positioned between the left and right ventricles in the case of TOF, though. As a result, in patients with TOF, deoxygenated blood may occasionally go to the aorta rather than the pulmonary artery.

Causes of Fallot’s Tetralogy

TOF is a congenital disorder, which may be triggered by several factors. Tetralogy of Fallot occurs as the baby’s heart develops during pregnancy. Usually, the cause is unknown.

In addition, children with genetic disorders often end up suffering from congenital heart defects as well, including TOF. The following risk factors that mothers are exposed to during pregnancy may cause TOF in infants:

  • Viral illness
  • Alcohol overuse
  • Diabetes
  • Poor or inadequate nutrition
  • Heredity factors
  • The presence of Down syndrome or DiGeorge syndrome in the baby
  • A mother older than age 40


  • Tetralogy of Fallot complications could include bacterial infections that affect the heart’s valves or inner lining (infective endocarditis). To avoid infections that can result in this infection, the doctor may advise taking antibiotics prior to several dental treatments for the parent or the child.
  • Untreated tetralogy of Fallot patients typically experiences serious consequences over time, which can lead to early adulthood mortality or disability.

Complications from Tetralogy of Fallot Surgery

While the majority of infants and adults recover well from tetralogy of Fallot defects (intracardiac repair) through open-heart surgery, long-term problems are frequent. Possible complications include:

  • Chronic pulmonary regurgitation, also known as leaking pulmonary valve, is a condition in which blood leaks through the valve and into the pumping chamber (right ventricle)
  • Tricuspid valve leak
  • Ventricular septal defects are holes in the wall between the ventricles that may leak even after repair or may require further treatment.
  • Irregular heartbeats or an enlarged right ventricle or a left ventricle that isn’t functioning properly (arrhythmias)
  • Cardiovascular disease
  • An increase in the ascending aorta’s size (aortic root dilation)
  • Unexpected cardiac death

Fallot’s Tetralogy Signs and Symptoms

Tetralogy of Fallot symptoms vary, depending on the amount of blood flow that’s blocked infant may also experience the following signs and symptoms:

  • Infants with Fallot’s tetralogy have bluish-tinted skin that can be seen on their lips and nails in addition to their skin. This demonstrated that their blood had insufficient oxygen levels.
  • If the baby becomes blue (cyanotic), placing the baby on his or her side and pulling the baby’s knees up to his or her chest may help. This helps increase blood flow to the lungs
  • Breathing difficulty – Tiredness and limping movement- Shortness of breath and rapid breathing, especially during feeding or exercise
  • Fainting
  • Loss of consciousness
  • Always fussy
  • Loss of response to a parent’s voice and touch
  • Low or no weight gain
  • Heart murmur
  • Clubbed fingernails- An abnormal, rounded shape of the nail bed in the fingers and toes.

If the infant exhibits any of the following signs or symptoms, get medical attention right away:

  • Difficulty breathing
  • Bluish discoloration of the skin
  • Passing out or seizures
  • Weakness
  • Unusual irritability

Fallot’s Tetralogy Diagnosis

Physical Examination: The doctor uses a stethoscope as part of a physical examination to first listen for the baby’s heartbeat and assess how well the baby’s heart is working. Also, they look at the infant’s general skin health, breathing rate, and facial expression.

Medical Examination: One or a combination of the following tests may be conducted to diagnose Fallot’s tetralogy:

Echocardiogram: This painless test makes use of ultrasound waves to check for the beating of the heart. The coloured picture of the heart on the screen lets doctors identify if there is any problem with the pumping of the blood.

Electrocardiogram: This test is used to monitor the electrical activity of the heart. It is a painless and safe test used to identify whether the heart is pumping regularly or not.

Cardiac catheterization: A narrow tube known as a catheter is threaded through the heart during this test after being put into a vein in the neck, arm, or groin. To monitor blood flow via the blood and heart vessels, a dye is injected into a vein. The pressure inside the heart chambers can be determined as well as if blood is mixing between chambers.

Pulse oximetry: This test helps assess the levels of oxygen in the blood.

X-ray of the chest: This test is used to take the picture of the heart and the lungs and identify the signs of fluid retention.

Tetralogy of Fallot Treatment in India

The term “tetralogy of Fallot” refers to a group of four (tetra) distinct congenital cardiac abnormalities. 5 out of every 10,000 newborns had this condition each year. Girls and boys are both equally susceptible to developing any of Fallot’s tetralogy disorders.

Children with congenital cardiac defects in India are advised to receive Fallot’s tetralogy therapy. It is an uncommon and complicated condition that interferes with the heart’s regular blood flow.

  • The major multispecialty hospitals in India offer treatment for Fallot’s tetralogy. The leading hospitals in India have all the necessary tools to successfully treat children with Fallot’s tetralogy medically and surgically.
  • There are neonatal intensive care units (NICUs), cardiac care units (CCUs), pediatric intensive care units (PICUs), and standard intensive care units (ICUs) among these high-end facilities (ICUs). Other cutting-edge amenities including artificial heart-lung bypass devices, oxygen tanks, life support systems, and cardiac monitors are also located on the hospital’s grounds.
  • In India, ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta are all treated as part of the tetralogy of Fallot syndrome. In India, VSD therapy is a standard cardiology procedure carried out at all significant multispeciality hospitals in India.
  • There are several cities in India where patients can get the top hospitals for the treatment of Fallot’s tetralogy. The majority of commercial flights connect these cities. The top Fallot’s tetralogy hospitals in India provide all-inclusive packages that are appealing to medical tourists and cover the cost of boarding, accommodation, medical care, and other amenities.

The Treatment

A cardiac (cardiovascular) surgeon must conduct corrective surgery on every infant with tetralogy of Fallot. Without therapy, the child might not develop and grow as it should. Based on the condition of the parent or the child, the doctor will choose the best procedure and the best time to perform it.

Some children may need medicine while waiting for surgery to maintain blood flow from the heart to the lungs.

Surgery or other procedures:

  • Open heart surgery to repair the flaws (intracardiac repair) or short-term therapy with a shunt are the two options for treating tetralogy of Fallot. The majority of infants and older kids get an intracardiac repair.
  • Several repairs are made during this open-heart procedure, which is often performed within the first year of life. In adults with tetralogy of Fallot who did not receive surgical correction as children, this surgery is very uncommon.

A surgeon performing an intracardiac repair will:

  • Closing the gap between the heart’s bottom chambers by covering the ventricular septal defect (ventricles).
  • To improve blood flow to the lungs, repair or replace the pulmonary valve that has become constricted.

Temporary shunt surgery:

  • Sometimes infants need a brief (palliative) operation before an intracardiac repair to enhance blood flow to the lungs. If your child was born preterm or has underdeveloped pulmonary arteries, this operation may be performed (hypoplastic).
  • With this technique, the surgeon builds a bypass (shunt) between the pulmonary artery and a sizable artery that arises from the aorta.

After Fallot’s Tetralogy Surgery

  • Those who have had tetralogy of Fallot surgery continue to have higher long-term survival chances.
  • After tetralogy of Fallot surgery, blood flow to the lungs might occasionally remain to be reduced. Further operations could be required. Adults who have had their tetralogy of Fallot fixed may later need to have their pulmonary valve replaced if they have a leaky pulmonary valve (pulmonary valve regurgitation).
  • Arrhythmias are a typical side effect of tetralogy of Fallot repair surgery. Your doctor might advise taking drugs, having the arrhythmias abated, or getting a specific pacemaker to manage life-threatening arrhythmias (implantable cardioverter-defibrillator).

Fallot’s Tetralogy Surgery Success Rate

Heart surgeons have a 100% survival rate in Tetralogy of Fallot repair.

Fallot’s tetralogy is a difficult and uncommon condition that can only be addressed by surgery. Since Fallot’s tetralogy comprises four distinct flaws that must be fixed, a surgeon will perform a variety of surgical procedures in order to treat the disorder.

The pulmonary blood arteries widened during Fallot’s tetralogy surgery. The vessels are either wider or completely replaced. The tube that joins the right ventricle to the pulmonary artery may also be widened or expanded by the surgeons if necessary. This enhances the blood’s flow to the lungs.

The surgeon also uses a patch to close the ventricular septal defect in addition to these procedures. Blood with and without oxygen does not mix as a result.

The problems caused by the other two heart defects in Fallot’s tetralogy can be resolved by fixing these two fundamental issues. As a result, the right ventricle can relax and stop pumping as quickly to maintain blood flow.

Recovery after Fallot’s Tetralogy Surgery

Recovery after TOF surgery takes months. The incision made during the surgery usually takes about six to eight weeks to heal completely. Sometimes, only temporary repair is done due to the small size of the infant. The infant is, therefore, made to undergo another surgery after a few years for full repair of the defects.

Extra care must be taken while feeding the infant after the surgery. He or she may need extra nutrition after the surgery. Consult your doctor about the feeding routine. Ideally, the baby should be fed at frequent intervals.

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Dr. Surbhi Suden

Verified By Dr. Surbhi Suden

Dr. Surbhi Suden is one of the founders of Lyfboat and a doctor with a renowned name in the Medical tourism industry. She has been working with international patients since 2008 and is a deeply committed professional with a long term vision of transforming the current healthcare scenarios.
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