Pediatric Heart Expert Forum
MILD Pulmonary stenosis with TOF
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MILD Pulmonary stenosis with TOF

Hi Doctor,

The following is the 2D ECHO and color doppler reports, which was taken on my new born baby, yesterday.  At the time of birth the baby did not turn blue, weighing 3500 grams and very active.  These defects identified previously as well with fetal echo scan twice at the time of the baby's 20 and 32 weeks of fetal maturity respectively.  Even those had same impression, the mild pulmonary stenosis remained the same till today.  Please go through the latest report and kindly let us know what is the impact of this on my baby, is there any way it can solve on its own? Based on the report impression whether we can treat the baby as a normal baby or still it has defect? Is surgery required?......totally confused...your comments would be of a great relief to me...please advice.

The latest 2D echo says as below:

Congenital Heart Disease
Tetralogy of fallot
large subaortic ventricular septal defect (6mm)
Bidiectional shunt across vsd
50% aortic override
Mild Pulmonary Stenosis
Peak and Mean PV Gradiant : 28 and 15 mmHg
Restrictive Osteum Secondum Type of Atrial Septal Defect (6mm)
Small left to right shunt across ASD
Confluent and fair sized MPA
Hypertrophied RV



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773637_tn?1327450515
Dear Narayan,

Your child has tetralogy of Fallot as well as a secundum atrial septal defect.  Tetralogy of Fallot does not resolve on its own and requires surgical intervention.  At this point, your child is asymptomatic.  However, with time, there will either be too much blood flowing rightward back across the ventricular septal defect to the right side of the heart, or not enough.  Either way, your child will not have normal heart function, and will need some sort of intervention if the baby will have a normal life span..  Based on what you are saying, this was diagnosed in utero and was confirmed by the echocardiogram performed after the baby was born—nothing has changed from the previous studies, with the exception that the anatomy can likely be better evaluated.  The degree of pulmonary stenosis is only one feature of this congenital heart defect, and only influences the timing (but not the need) for intervention.  Hopefully, your child will be able to get to be about two to four months of age prior to requiring surgery.
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Marie M Gleason, M.D.Blank
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The Children’s Hospital of Philadelphia
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