Which factors increase the risk for surgical repair of tetralogy of Fallot (TOF)?

Updated: Nov 13, 2018
  • Author: Shabir Bhimji, MD, PhD; Chief Editor: Yasmine S Ali, MD, FACC, FACP, MSCI  more...
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Answer

Factors that increase the risk for surgery in adult patients with tetralogy of Fallot include the following:

  • Cardiogenic shock

  • Poor RV function

  • Diminutive pulmonary arteries

  • Other major associated anomalies, such as tricuspid atresia or an anomalous coronary artery

  • Multiple previous surgeries

  • Advanced age

  • Severe annular hypoplasia

  • High peak RV–to–left ventricular pressure ratio

  • Multiple ventricular septal defects (VSDs)

  • Right-sided heart failure

See Treatment and Medication for more detail, as well as the Guidelines section for the 2018 American Heart Association/American College of Cardiology (AHA/ACC) recommendations for the management of adults with tetralogy of Fallot.


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