Tetralogy of Fallot

Our healthcare team will use various tests to diagnose your baby’s TOF so they can create the most personalized treatment plan. These tests could include:

• Prenatal ultrasound: Your provider usually does this test between 18 and 22 weeks of pregnancy to check for anything unusual with the heart or other organs.
• Fetal echocardiogram: This ultrasound helps diagnose TOF or other congenital heart conditions before birth.
• Newborn exam: Soon after birth, your provider will give your baby a physical exam and listen to their heart and lungs with a stethoscope. Children with TOF may have a heart murmur (a whooshing sound when blood moves abnormally over their heart valves).
• Pulse oximetry (Pulse ox): After your baby is born, our providers will put a painless clip on their toe or finger to measure the oxygen level in their blood. Many babies with TOF have levels that are lower than normal.
• Echocardiogram (Echo): This painless, noninvasive ultrasound shows your baby’s heart’s structure and how blood pumps through it. This test helps your provider diagnose TOF or other heart conditions after your child is born.

Meet Our Team

At Cleveland Clinic Children's, your child’s TOF care team could include:

• Pediatricians.
• Cardiac surgeons
• Cardiologists.
• Pulmonologists.
• Radiologists.
• Neurodevelopmental physicians.
• Nurse practitioners.
• Physician assistants.
• Social workers.
• Child life specialists.
• Care coordinators.
• Other specialists if there are co-existing conditions.

If your baby has TOF, they’ll need surgery to repair it. Our team of congenital heart surgeons will usually do surgery within your child’s first year. But we also have experience doing this surgery on older children. Successful surgery can raise your child’s blood oxygen levels and improve blood flow through their heart and to their lungs.

Temporary treatment for tetralogy of Fallot

Our team will talk with you about the best time for your baby to have surgery. If your baby is premature or has other health conditions, we may recommend delaying your baby’s surgery.

In these cases, we may do a less invasive procedure to improve your baby’s symptoms until they’re ready for the complete surgical repair. Although these procedures won’t fix TOF, they can help increase your baby’s oxygen levels. These temporary treatments include:

• Shunt procedure: Your provider may place a shunt (tube) in your baby’s pulmonary artery. This is a minimally invasive procedure that creates only a small incision (cut). The shunt lets more blood flow into their lungs.
• Newborn stent procedure: Newborns have an artery called the ductus arteriosus that naturally closes soon after birth. Your provider can place a stent (mesh tube) in this artery to keep it from closing and increase blood flow to your baby’s lungs.

Long-term care for tetralogy of Fallot

Your child’s care doesn’t end after successful TOF surgery. Our team will provide complete medical care and support into adulthood, including:

• Heart checkups from our experienced cardiologists.
• Testing to see how their heart is working.
• Mental health care or counseling if they have anxiety, depression or other mental health needs.
• Recommendations for playing sports.
• Resources and support groups to help you connect with others who understand your challenges.

Taking the Next Step

Having a new baby can be overwhelming enough. But when your baby has a serious heart disorder like tetralogy of Fallot, you might be left wondering how to handle it all. That’s where we come in. We’ll partner with you every step of the way — from your child’s birth and throughout adulthood. At Cleveland Clinic Children's, we’ll give your child — and you —the expert, compassionate care and support you need.