Continued Care in Female Patients with Tetralogy of Fallot into Adulthood and Pregnancy

Continued Care in Female Patients with Tetralogy of Fallot into Adulthood and Pregnancy

Tetralogy of Fallot (TOF) is a congenital heart disease with four distinct characteristics: pulmonary valve stenosis, overriding aorta, right ventricular hypertrophy (RVH), and ventral septal defect (VSD). Surgical correction is now an option with 98% survival rate. Patients with repaired TOF (rTOF) often reach adulthood and can transition out of pediatric care. Unfortunately, providers trained to care for adults with congenital heart defects are not readily available. This has caused a lapse in care for many individuals with TOF. Additionally, providers trained to care for patients with congenital heart defects are needed to monitor patients with pre-pregnancy counseling and throughout pregnancy. Maternal cardiac complications occur in 7% to 10% of pregnancies in patients with rTOF, the most common complications being arrhythmia and symptomatic heart failure. With a pregnancy and delivery plan in place, along with close monitoring of both mother and fetus, pregnancy is well tolerated in women with rTOF. Equipping providers to manage adults with congenital heart defects, along with patient education and access to care, are key factors in lifelong management of TOF.