Correcting Tetralogy of Fallot in a Single Operation
Tetralogy of Fallot was in the news, as talk show host Jimmy Kimmel described the birth of his son whose skin turned a purplish hue with the first few hours. The infant underwent open-heart surgery in Los Angeles to relieve a blocked pulmonary artery and further operations will be needed to correct other heart defects.
At NYP Morgan Stanley Children’s Hospital, pediatric cardiac surgeons are making great advances in the surgery for infants with this condition, addressing tetralogy of Fallot in a single-stage operation. “We typically we operate a little later, when the child is three to six months of age,’ says Emile Bacha, MD, Chief of the Division of Cardiac, Thoracic & Vascular Surgery and Director of Congenital and Pediatric Cardiac Surgery. “Today, we can do what was once at least a two-stage procedure in a single surgery for the majority of our patients, depending upon their anatomy.”
For complex cases, Columbia surgeons use 3D printing to make a model of the infant’s heart. Dr. Bacha, who was the first to use 3D printing in pediatric cardiac surgery in 2014, says, “We also have excellent outcomes—our mortality rate and serious morbidity for children with tetralogy of Fallot is almost zero.”
“The one-stage operation is done through a small incision, for cosmetic reasons,” says Dr. Bacha. “It is a well tolerated procedure, though the majority of infants still end up with pulmonary regurgitation later on, and eventually need a valve implantation. Until then, however, they can have a normal life. They engage in sports, and as they come age, get pregnant, and have children. And, when they finally need the valve implantation, it’s a fairly straightforward procedure.”
At NYP Morgan Stanley, pediatric cardiac surgeons now perform about 40 operations for tetralogy of Fallot each year. Our hospital has a world-renowned program for Congenital Heart Surgery, and is consistently ranked by U.S. News & World Report as one of the top children’s hospitals in the nation.