Tetralogy of Fallot is the most common form of cyanotic congenital heart disease. If your baby is unfortunately diagnosed with this congenital heart disease, young mothers and fathers, grandparents must be very nervous and eager to learn something about Faroquadruplex, but due to the lack of medical science knowledge in China at present, the professional interpretation of doctors is sometimes difficult for parents of affected children to understand. Even after a doctor’s explanation, parents still do not know how to care for, feed and treat their unfortunate babies with Tetralogy of Fallot.
Today, I will briefly introduce this common congenital heart disease and focus on parents’ concerns about feeding, care, clinical follow-up, timing of surgery and the importance of postoperative follow-up.
I. What is tetralogy of Fallot
The so-called tetralogy of Fallot refers to four malformations of the heart, namely pulmonary stenosis, ventricular septal defect, aortic span, and right ventricular hypertrophy. It manifests as varying degrees of hypoxia because a large amount of unoxygenated blood is shunted into the body circulation. The child presents with bruised lips, and older children are reluctant to move and walk. Pulmonary stenosis leads to less blood in the lungs and poorly developed pulmonary arteries. Stenosis can also lead to right ventricular hypertrophy, and the more severe the stenosis, the more severe the hypertrophy of the heart.
II. Feeding and home care for babies with tetralogy of Fallot
Most babies with tetralogy of Fallot have no obvious symptoms after birth, and there are no feeding problems. Parents just notice that the child’s mouth and lips are purple in color when they cry. Some babies with tetralogy of Fallot may show varying degrees of difficulty breastfeeding after birth, with difficulty feeding and with obvious cyanosis. For these babies, when breastfeeding, remember to block the child’s nostrils, do not breastfeed in an unconscious state, and make sure to give the child more water in between feedings, as water can dilute the blood and relieve the child’s lack of oxygen.
Babies with tetralogy of Fallot are generally not prone to colds and fever. If they appear, they should be examined in hospital in time to avoid bacterial thrombosis due to slow blood flow.
Try to avoid the baby crying, because when crying for a long time can appear severe hypoxic performance, the baby may show sudden fainting, clinical called paroxysmal hypoxic attack. If this happens, immediately bend the child’s legs to the chest and pat the child, which usually relieves the hypoxic attack, and oxygen can be given if possible.
For babies who have not yet undergone surgical treatment, if available, an oxygen bag can be given at home and the child can be given oxygen for 1-2 hours a day.
Third, the baby with tetralogy of Fallot’s follow-up and the timing of surgery
The diagnosis of tetralogy of Fallot is easier to make clinically, and the child is usually diagnosed in the neonatal period, but when to treat the child is the most important concern of parents.
Because there is no possibility of self-healing for babies with tetralogy of Fallot, surgical correction is currently the only treatment option. For most babies with tetralogy of Fallot, surgery is usually chosen between June and December.
Currently, many primary care physicians and pediatricians are not clear about the timing of surgery for tetralogy of Fallot from the experience of parents of children in outpatient clinics, and they suggest that children should not be operated until after the age of 1 or even 2 years, otherwise they will not survive (original words of parents of children with the disease).
Therefore, it is recommended that children with tetralogy of Fallot be reviewed every 3 months at a local hospital that is capable of performing heart surgery, so that an appropriate time for surgery can be chosen based on the child’s condition.
For children with recurrent episodes of hypoxia, bruising that is very obvious or gradually worsening, and combined infections during the follow-up process, early surgery should be considered. Nanjing Children’s Hospital has had 155 consecutive cases without death.
IV. Post-operative follow-up of babies with tetralogy of Fallot
At present, the long-term follow-up reports of overseas surgery for tetralogy of Fallot show that the long-term survival rate is about 90%, and the quality of life of children with the disease can reach the level of normal people in adulthood, and they can participate in work and light labor, without affecting marriage and children (which is also a concern of Chinese parents).
The common postoperative complications in children with tetralogy of Fallot are right heart insufficiency and ventricular arrhythmias, which are also the main causes of death in the long term.
Therefore, postoperative follow-up of tetralogy of Fallot is very important, and children are now required to be routinely reviewed at 1 month, 3 months, 6 months, and 1 year after surgery, and generally postoperative cardiac diuretics should be taken for 3 months. after 3 months, the medication is discontinued according to the situation.
After 1 year, it is recommended that the child should have an annual cardiac ultrasound, electrocardiogram and chest X-ray, regardless of symptoms, in order to assess cardiac function in a timely manner, detect potential problems and minimize complications or intervene in a timely manner in case of complications. Also at this stage most children are in school and the results of the review are also useful in guiding the amount of activity and whether the child can attend physical education classes, etc.
In conclusion, I tell parents of unfortunate babies with Tetralogy of Fallot: although Tetralogy of Fallot is a complex congenital heart disease, this precocious heart disease is treatable and the treatment is very effective, but attention must be paid to post-operative follow-up so that the child can grow up to be a healthy and happy adult.