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Tetralogy of Fallot


Tetralogy of fallot is the most common form of cyanotic heart defects, more commonly known as "blue babies." Infants are diagnosed at birth through an abnormal newborn screening, by detecting a murmur, or by seeing the baby is not a normal color.

Tetralogy of fallot includes four different heart problems:

  • Pulmonary stenosis (a narrowing of the blood vessel to the lungs)
  • An overriding aorta (the main blood vessel from the heart to the entire body is displaced)
  • A ventricular septal defect (hole in the wall between the lower two chambers of the heart)
  • Right ventricular hypertrophy (a thick muscle in the right pumping chamber)

Normal heart – in a healthy heart with proper blood flow, the blue droplets representing oxygen-poor blood travel to the lungs, and the red oxygen-rich droplets circulate through the body.

A heart with tetralogy of fallot.


Cardiac surgeons perform primary total repair in most children with a surgical procedure. The animated videos below show blood flow in a heart with tetralogy of fallot and indicate how repairs are made.

Heart with tetralogy of fallot

Temporary repair – occasionally, if a baby is very blue at birth but is at low birth weight or has very small pulmonary arteries, the surgeon may perform a temporary shunt procedure until the child has grown enough for a total repair.

A total repair of tetralogy of fallot is a surgical procedure using a patch or tube that includes:

  • General anesthesia
  • Opening the chest in the center
  • Using cardiopulmonary bypass
  • Closing the hole
  • Cutting out any muscle under the pulmonary valve
  • Opening up the narrowest area to allow easy blood flow to the lungs

A total repair of tetralogy of fallot may involve inserting a tube to create a path for blood to the lungs.