Meet VW’s Super Bowl “Darth Vader”

With an audience in the neighborhood of 100 million people, it’s no surprise that advertisers pull out all the stops for their Super Bowl ads, especially when it is reported that half the viewers watch the game for the commercials alone. The most popular commercial last night, by many accounts, was a Volkswagen commercial where a young boy  tries to “channel his inner Darth Vader”:

Who is the boy behind the mask? It’s 6-year-old Max Page, who was a member of the cast of “The Young and the Restless” from 2009-10 playing Reed Hellstrom. At 3 months of age, Max was diagnosed with a congenital heart condition called Tetralogy of Fallot. He underwent heart surgery at Los Angeles Children’s Hospital. His mother, Jennifer, told Matt and Meridith on the Today show this morning:

“He had his first surgery when he was 3 months old at Children’s Hospital in Los Angeles. They saved his life and gave him back to us about a week after his first surgery. He had to have a pacemaker put in, so he has maintenance on that.”

According to his surgeon, Dr. Michael Silka, “Max’s prognosis going forward is very good. He can essentially have normal activity and with careful care, a full life is a reasonable expectation.”

What Is Tetralogy of Fallot?

(Source: NHLBI)

Tetralogy (teh-TRAL-o-je) of Fallot (fah-LO) is a congenital heart defect, which is a problem with the heart’s structure that’s present at birth. This type of heart defect changes the normal flow of blood through the heart. Tetralogy of Fallot is a rare, complex heart defect that occurs in about 5 out of every 10,000 babies. It affects boys and girls equally.


Tetralogy of Fallot involves four heart defects:

  1. A large ventricular septal defect (VSD)- a hole in the part of the septum that separates the ventricles- the lower, pumping chambers of the heart. The hole allows oxygen-rich blood from the left ventricle to mix with oxygen-poor blood from the right ventricle.
  2. Pulmonary stenosis– a narrowing of the pulmonary valve and the passage through which blood flows from the right ventricle to the pulmonary artery. Normally, oxygen-poor blood from the right ventricle flows through the pulmonary valve, into the pulmonary artery, and out to the lungs to pick up oxygen. In pulmonary stenosis, the heart has to work harder than normal to pump blood, and not enough blood reaches the lungs.
  3. Right ventricular hypertrophy-the muscle of the right ventricle thickens because the heart has to pump harder than it should to move blood through the narrowed pulmonary valve.
  4. An overriding aorta-a defect in the aorta, the main artery that carries oxygen-rich blood to the body. In a healthy heart, the aorta is attached to the left ventricle. This allows only oxygen-rich blood to flow to the body. In tetralogy of Fallot, the aorta is between the left and right ventricles, directly over the VSD. As a result, oxygen-poor blood from the right ventricle flows directly into the aorta instead of into the pulmonary artery to the lungs.

Together, these four defects mean that not enough blood is able to reach the lungs to get oxygen, and oxygen-poor blood flows out to the body.

Babies and children who have tetralogy of Fallot have episodes of cyanosis (si-a-NO-sis), a bluish tint to the skin, lips, and fingernails. Cyanosis occurs because the oxygen level in the blood is below normal.

Tetralogy of Fallot must be repaired with open-heart surgery, either soon after birth or later in infancy. The timing of the surgery depends on how severely the pulmonary valve is narrowed.

Surgery to repair tetralogy of Fallot is done to improve blood flow to the lungs and to make sure that oxygen-rich and oxygen-poor blood flows to the right places. The surgeon will:

  • Widen the narrowed pulmonary blood vessels. The pulmonary valve is widened or replaced, and the passage from the right ventricle to the pulmonary artery is enlarged. These procedures improve blood flow to the lungs. This allows the blood to get enough oxygen to meet the body’s needs.
  • Close the ventricular septal defect (VSD). A patch is used to cover the hole in the septum. This patch stops oxygen-rich and oxygen-poor blood from mixing between the ventricles.

Fixing these two defects resolves problems caused by the other two defects. When the right ventricle no longer has to work so hard to pump blood to the lungs, it will return to a normal thickness. Fixing the VSD means that only oxygen-rich blood will flow out of the left ventricle into the aorta.

Over the past few decades, the diagnosis and treatment of tetralogy of Fallot have greatly improved. As a result, most children who have this heart defect survive to adulthood.

For more information about Tetralogy of Fallot, click here to go to the Resounding Health Casebook on the topic

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.


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