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Your Child's Tetralogy of Fallot Surgery

Heart surgery for TOF is performed by a pediatric heart surgeon. The surgery lasts about 4–6 hours. It takes place in an operating room in a hospital. You’ll stay in the waiting room during surgery.

Front view cross section of heart showing repair for Tetralogy of Fallot. Pulmonary artery widened with patch. Area below pulmonary valve widened. Ventricular septal defect repaired with patch.
After repair of TOF, blood flow from the heart to the lungs is restored to normal. The VSD is closed, which prevents blood from mixing.

  • Before surgery:  You’ll be told to keep your child from eating or drinking anything for a certain amount of time before surgery. Follow these instructions carefully.

  • During surgery:  Your child is given medication (sedative and anesthesia) to help him or her sleep and not feel pain during surgery. A breathing tube is placed in your child’s trachea (windpipe). Special equipment monitors your child’s heart rate, blood pressure, and oxygen levels. An incision is made in the chest through the sternum (breastbone) to access the heart. Your child is placed on a heart-lung bypass machine. This allows blood to continue flowing to the body so the heart can be operated on. The VSD is repaired with a patch. Tissue causing obstruction at or below the pulmonary valve is removed as needed. The first part of the pulmonary artery may be made larger with a patch. Then, your child is taken off the bypass machine and the chest is usually closed.

  • After surgery: Your child is taken to a critical care unit to be cared for and monitored. You can stay with your child during much of this time. He or she may remain in the hospital for 3–10 days. When your child is ready to leave the hospital, you’ll be given instructions for home care. 

When to Call the Doctor

After heart surgery, call the doctor right away if your child has any of the following:

  • Increased redness, draining, swelling, or bleeding at the incision site

  • Fever 100.4°F or higher

  • Trouble feeding

  • Tiredness

  • Shortness of breath

  • Cough that won’t go away

  • Nausea or vomiting

  • Irregular heartbeat

What Are the Long-term Concerns?

  • Regular follow-up visits with the cardiologist are needed for the rest of your child’s life. Further pulmonary valve treatment may be needed in the future. Your child may also develop heart rhythm problems that may need to be treated.

  • After repair of TOF, most children can be active. The level and extent of physical activity will vary with each child. Check with the cardiologist about what activities are appropriate for your child.

  • Your child may always need to take antibiotics before having any surgery or dental work. This is to prevent infection of the inside lining of the heart and valves. This infection is called bacterial endocarditis. Antibiotics should be taken as directed by the cardiologist.

Online Medical Reviewer: Evangelista, Juli-anne, MS, ARNP, BC, PNP
Online Medical Reviewer: Yoon, Eunice, MD, MPH
Last Review Date: 2/2/2012
© 2000-2014 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.