Every year, 100,000 babies don't make it to their first birthday because of CHD.
chd, congenital heart disease, tetralogy of fallot

Trent Timothy Harding is our Heart Warrior of the Week! Trent was born on November 30th, 2010, but wasn’t diagnosed with Tetralogy of Fallot until he was 5 weeks old. He has undergone two open-heart surgeries throughout his journey with CHD. The first was an emergency surgery in which a full repair was completed after he was diagnosed at 5 weeks old.  The second was for a pulmonary valve repair that took place when he was 6 years old.

Trent has spent a total of 21 days in the hospital during his battle with congenital heart disease. He will have to undergo an unknown number of valve replacements throughout his life, but his mom, Stephanie, is hopeful technology will advance and those can be inserted via the femoral artery and not via an open-heart surgery.

Stephanie describes her son as brave, strong, and courageous.

chd, congenital heart disease, tetralogy of fallot, TOF

About Tetralogy of Fallot (TOF)

Anatomy: TOF is actually four heart defects in one, they include – ventricular septal defect (VSD), pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta.

 

Ventricular Septal Defect (VSD)
The heart has an inner wall that separates the two chambers on its left side (left atrium & left ventricle) from the two chambers on its right side (right atrium and right ventricle). A VSD is a hole in the septum between the heart’s ventricles that allows oxygen-rich blood from the left ventricle to mix with oxygen-depleted blood from the right ventricle.

Pulmonary Stenosis
This defect involves the narrowing of the pulmonary valve, creating an obstruction when blood tries to flow from the right ventricle to the pulmonary artery to receive oxygen from the lungs. With pulmonary stenosis, the pulmonary valve cannot fully open.  Thus, the heart must work harder to pump blood through the valve.  As a result, not enough blood reaches the lungs.

Right Ventricular Hypertrophy
With this defect, the muscle wall of the right ventricle becomes enlarged due to underlying causes that put added stress on this part of the heart. 

Overriding Aorta
This defect occurs when the aorta, the main artery that carries oxygen-rich blood from the heart to the body, is displaced between the ventricles and directly over the VSD. 

Complications: With Tetralogy of Fallot, not enough blood is able to reach the lungs to get oxygen, and oxygen-poor blood flows to the body, resulting in dangerously low oxygen saturations. Pulmonary stenosis puts additional strain on the heart, resulting in it overworking itself.

Symptoms: A bluish coloration of the skin (cyanosis), shortness of breath, rapid breathing especially during feeding or exercise, fainting, poor weight gain, tiring easily during play or exercise, heart murmurs and tet spells (sudden development of deep blue skin, nails and lips after crying, feeding, or when agitated).

Treatment: Tetralogy of Fallot is repaired with open-heart surgery to repair all four defects. Additional surgeries throughout adolescence and adulthood are common to repair or replace the pulmonary valve.

Prevalence: This is one of the more common CHD’s occurring in ~5 out of 10,000 live births.

**Some babies born with TOF have additional heart defects, like pulmonary atresia.  With this defect, the pulmonary valve doesn't form correctly.  Instead of opening and closing to allow blood to travel from the heart to the lungs, a solid sheet of tissue forms. Because of this, blood can't travel by its normal route to pick up oxygen from the lungs.  In some cases, small amounts of blood are able to travel to the lungs through other natural passages within the heart and its arteries.

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