Tetralogy of Fallot

Tetralogy of Fallot (TOF) is a congenital heart defect that affects the flow of blood from the heart to the lungs. It is usually diagnosed shortly after birth, but in some parts of the world, children reach toddlerhood or even adulthood without corrective surgery due to limited access to advanced cardiac care.

India has become one of the world’s most reliable and affordable destinations for TOF treatment, thanks to its internationally trained pediatric cardiac surgeons, advanced children’s hospitals, and significantly lower costs. Families from Africa, the Middle East, South Asia, and Europe travel to India to give their children a chance at a healthy, normal life. The cost of TOF treatment in India ranges from USD 5,500 to USD 12,000.

What is Tetralogy of Fallot (TOF)?

Tetralogy of Fallot is a congenital heart condition consisting of four key defects:

1. Ventricular Septal Defect (VSD): A hole between the lower heart chambers.
2. Pulmonary Stenosis: Narrowing of the pulmonary valve or artery.
3. Overriding Aorta: The main artery sits over the VSD instead of the left ventricle.
4. Right Ventricular Hypertrophy: Thickening of the right heart muscle.

These defects reduce oxygen levels in the blood, causing the baby to appear bluish (cyanotic). Without surgery, children face significant health risks, but with proper treatment, they can grow normally and live full lives.

Types of Tetralogy of Fallot (TOF) Treatment Procedures

India offers multiple treatment techniques based on the child's age, weight, and severity of obstruction.

1. Complete Repair Surgery (Preferred Method)

This is the most common and recommended treatment. Surgeons close the VSD, widen the pulmonary valve or artery, and repair the heart’s structure. Most children undergo complete repair between 3 and 12 months of age, but it can be performed safely even in older children.

2. Temporary or Palliative Shunt Surgery

In very small infants or children who are unstable, surgeons may perform a shunt procedure (Blalock-Taussig shunt) to improve blood flow temporarily. The full repair is completed later when the child is stronger.

3. Valve-Sparing TOF Repair

In selected cases, surgeons preserve the pulmonary valve to avoid long-term complications and reduce the need for future valve replacement.

4. Adult TOF Repair

Some adults with uncorrected TOF or residual defects require late surgical correction. Indian cardiac centers specialize in these complex cases.

Who is a Good Candidate for Tetralogy of Fallot Treatment?

A child is considered a good candidate if they have:

• Confirmed TOF diagnosis
• Low oxygen saturation levels
• "Blue spells" or breathing difficulty
• Failure to gain weight
• Chronic fatigue or fainting
• Severe pulmonary stenosis
• Unrepaired TOF beyond infancy

Even older children and adults who never received surgery can be treated successfully in India.

Pre-Surgery Preparation & Diagnostics

Before surgery, doctors conduct a detailed assessment to plan the safest approach.

Pre-surgery evaluation usually includes:

• Echocardiography (ECHO)
• Chest X-ray
• ECG
• 3D CT angiography (in complex cases)
• Oxygen saturation tests
• Blood tests
• Screening for infections
• Nutritional assessment

International patients can send medical reports digitally for early surgical planning before travel.

What’s Included in the TOF Treatment Package?

Usually Included:

• Pediatric cardiologist consultation
• Pediatric cardiac surgeon fees
• Operation theatre charges
• ICU stay (2-4 days)
• Ward stay (5-7 days)
• Anesthesia
• Nursing care
• Medicines & consumables
• Routine diagnostics
• Follow-up during stay

Not Usually Included:

• International travel
• Post-discharge medicines
• Extended ICU stay (if complications occur)
• Hotel accommodation
• Future valve replacements (if needed years later)