Tetralogy of Fallot (TOF) is a critical heart defect that requires repair in the first year of life, and in the most severe cases, even in the first weeks of life. In Germany, the disease is successfully cured without any consequences for the child's health. The development of the child is not impaired if the repair surgery is performed at the age of up to 3 years. You are welcome to use the Booking Health service to get medical care at one of the best German hospitals. On our website, you can find the real cost of treatment in Germany, compare prices, and choose a medical care program for your preferred dates.
Content
- What is tetralogy of Fallot (TOF)?
- When can a complete intracardiac repair of tetralogy of Fallot (TOF) be performed?
- How is a complete intracardiac repair of tetralogy of Fallot (TOF) performed?
- Why to undergo your tetralogy of Fallot (TOF) treatment in Germany?
What is tetralogy of Fallot (TOF)?
This is a heart defect characterized by impaired patency of the pulmonary artery, impaired blood flow from the right ventricle, a large hole in the septum between the ventricles, and right ventricular thickening.
Different children have different grades and severity of the defect. It may also have different anatomical features that affect the patient's condition, the timing of treatment, and a surgical technique to eliminate the disease.
The pathology is usually diagnosed immediately after the child's birth. This condition is manifested by bluish skin, heart murmurs, and episodes of shortness of breath. If the child has a mild right ventricular outflow tract obstruction, symptoms may be mild, and the blue tint of the skin becomes noticeable only after a few months.
When can a complete intracardiac repair of tetralogy of Fallot (TOF) be performed?
A complete intracardiac repair for tetralogy of Fallot (TOF) can be performed:
- at the first stage of treatment;
- at the second stage of treatment, after palliative surgery for tetralogy of Fallot.
Doctors give priority to the primary complete intracardiac repair of tetralogy of Fallot. In this case, all problems with the heart and large blood vessels can be solved in one operation, completely restoring hemodynamics.
Some patients, however, are in critical condition. They cannot endure a complex, traumatic operation. Due to the high risk of complications, it is postponed, and a minimally invasive procedure or non-traumatic surgery is performed to stabilize hemodynamics, which does not completely eliminate the defect but normalizes hemodynamics by improving communication between the systemic and pulmonary circulations.
The optimal age for the repair of tetralogy of Fallot (TOF) is 6-12 months. In this case, the operations are most successful because they ensure the survival of patients on average at 98%, and at the best German hospitals, this indicator is 100%. In some cases, earlier repair of tetralogy of Fallot (TOF) is required. The operation can be performed even in the first month of a child's life, including in a premature newborn, but in this case, the risks of surgery increase.
Below are some of the conditions required for the complete intracardiac repair of tetralogy of Fallot (TOF):
- good general health condition of the patient;
- heart disease is operable;
- hemodynamics are stable;
- hemoglobin levels are below 190 g/L;
- blood oxygen saturation is over 70%;
- no attacks of shortness of breath with cyanosis (blueness).
If these criteria are not met, preparation for the complete intracardiac repair of tetralogy of Fallot is required, which may include both drug therapy and palliative procedures or operations.
How is a complete intracardiac repair of tetralogy of Fallot (TOF) performed?
The task of doctors is the complete elimination of pulmonary stenosis and reconstruction of the interventricular septum to repair its defect. These manipulations are carried out in one step whenever possible. A two-stage approach is less commonly used, in which the pulmonary stenosis is eliminated first and the interventricular septum is repaired during the second operation. Surgeons at some German hospitals perform the second stage using an endovascular technique, that is, through the blood vessels without any chest incisions. Furthermore, transcatheter interventions are already being used in clinical trials to completely eliminate tetralogy of Fallot (TOF) through a minimally invasive method that does not require open surgery. It is possible that in the near future, many patients will be able to receive interventional repair instead of open surgery with comparable results.
But so far, the defect can only be repaired with the help of open surgery. Doctors open the patient's chest and connect them to a heart-lung machine. The pulmonary trunk is dilated with a patch. If it is necessary to increase the area of the heart valve, a commissurotomy may be performed, which serves to dissect the heart valve leaflets. The interventricular septum is repaired by applying a patch. In some cases, it is also necessary to excise the muscle tissue of the right ventricle because of its severe hypertrophy.
Why to undergo your tetralogy of Fallot (TOF) treatment in Germany?
If you need surgery to repair tetralogy of Fallot (TOF), you can undergo your treatment in Germany. German hospitals have state-of-the-art equipment and employ world-famous cardiac surgeons. There are a few reasons for you to seek medical attention at one of the German hospitals for tetralogy of Fallot repair. These are the following:
- preference is given to one-stage treatment;
- the lethality of patients at the best hospitals is close to zero;
- a low risk of complications;
- a low probability of needing revision operations in the future;
- complete repair in the case of heart disease, which ensures the restoration of normal hemodynamics and the absence of any developmental delays in a child;
- successful repair at any age, including in newborns and adults.
On the Booking Health website, you can find out the cost of treatment in Germany and compare prices in different German hospitals. When you make an appointment through Booking Health, the cost of treatment in Germany will be lower for you than if you contact a Cardiac Surgery Center directly. The price is reduced due to the absence of additional taxes for foreign patients.
Medical tourism agency Booking Health will organize your treatment in Germany. We will select a Cardiac Surgery Center, contact the administration of the medical facility, and schedule an appointment for your preferred dates. We will also translate your medical records into German, book the nearest hotel to the hospital, and buy airline tickets. Our company's specialists will meet you at the airport in Germany and take you to the Cardiac Surgery Center by car. After the completion of your treatment, your return transfer will be organized.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
European Society of Cardiology
American College of Cardiology
Medscape
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