Tetralogy of Fallot Repair

Tetralogy of Fallot is a heart condition present from birth that combines a hole between the pumping chambers, a narrowed outlet to the lungs, an aorta that sits over the hole and a thickened right ventricle. Repair is open heart surgery that closes the hole and widens the route to the lungs.

Complete repair usually gives children normal oxygen levels and a near normal childhood. It is not a lifelong cure: the pulmonary valve often leaks afterwards and many people need a valve replacement in their teens or adult life, so follow-up by a congenital cardiologist never stops.

What Tetralogy of Fallot Repair involves

The child is assessed with echocardiography and sometimes CT or cardiac catheterisation to map the pulmonary arteries and coronary arteries. Under general anaesthetic the chest is opened through the breastbone and a heart-lung machine takes over the circulation. The surgeon closes the ventricular septal defect with a patch so that the aorta receives blood only from the left ventricle. Obstructing muscle below the pulmonary valve is cut away, and the valve and artery are enlarged, with a patch across the valve ring if it is too small or by preserving the valve when size allows. The heart is restarted, the repair is checked with echocardiography in theatre and the chest is closed.

Who is a good candidate for Tetralogy of Fallot Repair?

Most babies have a planned complete repair between about 3 and 12 months of age. Timing depends on oxygen levels and anatomy.

• Infants with confirmed tetralogy and pulmonary arteries of adequate size
• Babies with falling oxygen saturations or cyanotic spells, who need earlier surgery
• Older children or adults who were never repaired or only had a shunt
• Adults after repair who now need pulmonary valve replacement

It is usually not the right choice if:

• Very small or premature babies, where a temporary shunt or stent may come first
• Very underdeveloped pulmonary arteries that need staged procedures
• An unwell child with an active infection, until it has cleared
• A baby having frequent cyanotic spells is an emergency and should be treated locally, not flown abroad

Technique options

• Complete primary repair: One operation closing the hole and relieving the obstruction. Standard approach in most infants.
• Valve-sparing repair: Keeps the child's own pulmonary valve when it is large enough, aiming to reduce later leakage.
• Transannular patch: A patch across a small valve ring. Relieves obstruction well but leaves a leaking valve.
• Palliative shunt or outflow stent: A temporary measure to raise lung blood flow in small or unstable babies before full repair.
• Pulmonary valve replacement: Surgical or catheter-delivered valve for leakage years after the original repair.

What happens during your treatment

The operation lasts 3 to 5 hours under general anaesthetic. Your child wakes in a paediatric cardiac intensive care unit with a breathing tube, chest drains and monitoring lines, and usually stays there for 2 to 4 days. One parent can normally be at the bedside for most of the day.

Preparing for your trip

Plan for 4 to 5 weeks in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

Total hospital stay is commonly 7 to 14 days. Babies feed and handle normally within a couple of weeks, though the breastbone takes about 6 weeks to heal, so lifting under the arms is avoided. Plan to stay near the hospital for at least 2 weeks after discharge and fly only when the surgical team agrees. Lifelong checks with echocardiography, ECG and later cardiac MRI are needed at home.

• Back to everyday activity: 6 weeks for the breastbone to heal
• When results show: Oxygen levels normalise immediately
• How long they last: Lifelong follow-up; later valve replacement is common

Safety, risks and revision policy

Outcomes in experienced congenital heart units are good, with survival above 95 percent, but this is major surgery in a small child.

• Heart rhythm disturbances, including heart block that may need a pacemaker
• Bleeding that needs a return to theatre
• Low heart output in the first days, needing medicines or support
• A small leftover hole or residual narrowing
• Fluid around the heart or lungs
• Infection of the wound or chest
• Pulmonary valve leakage over the years, leading to right ventricle enlargement
• Late arrhythmias in adult life

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Tetralogy of Fallot Repair in Türkiye

Clinic-Y does not publish a single price for Tetralogy of Fallot Repair, because the honest figure depends on your case. What moves it:

• Complexity of the anatomy and whether staged procedures are needed
• Days in paediatric intensive care
• Pre-operative imaging such as CT or catheterisation
• Length of stay for the child and accompanying parent

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions