Cyanotic spells usually respond to oxygen, morphine, and the knee-to-chest position. These spells are usually a sign that surgery is needed.
Sometimes an injection of a hormone called prostaglandin E can help improve blood flow through the lungs. This is done until surgery can repair the problem.
Open heart surgery is done to close the hole in the septum, remove extra heart muscle, and open or repair the pulmonary valve. This surgery is recommended as early as possible in nearly all cases. It can be done only if the child has well-developed pulmonary arteries. These arteries carry blood to the lungs. If they are not well developed, temporary surgery may be done to increase blood flow to the lungs. This will give a child some time until the arteries develop more and full repair can be done.
Prostaglandin E can stop a child's breathing. It should be used in a setting where resuscitation equipment is available. Surgery may cause bleeding, infection, and allergic reaction to anesthesia.
Other problems can arise after surgery. Restoring normal blood flow may trigger the following:
After surgery, improvements should be seen in the symptoms linked to low-oxygen levels, such as cynanotic spells, and the child's tolerance of exercise. However, heart function is not fully normal. A variety of problems called heart blocks and, rarely, sudden death can occur years after surgery.
Visits to the doctor are scheduled regularly to check that the heart is healing properly and that there are no new symptoms. Testing may need to be repeated to ensure that heart disease is not worsening. People who have had tetralogy of Fallot should take antibiotics before any future surgery or dental work. This will help them avoid serious heart infections. Any new or worsening symptoms should be reported to the healthcare provider.