What are the possible complications of tetralogy of Fallot (TOF) surgical repair?

Updated: Nov 13, 2018
  • Author: Shabir Bhimji, MD, PhD; Chief Editor: Yasmine S Ali, MD, FACC, FACP, MSCI  more...
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Early postoperative complications following repair of tetralogy of Fallot (TOF) include the creation of heart block and residual ventricular septal defects (VSDs). Ventricular arrhythmias are more common and are reportedly the most frequent cause of late postoperative death. Sudden death from ventricular arrhythmias has been reported in 0.5% of individuals within 10 years of repair. The arrhythmias are thought to occur in fewer than 1% of patients having an early operation. As with most heart surgery, the risk of endocarditis is lifelong, but the risk is much less than in a patient with an uncorrected tetralogy of Fallot.

Surgery to manage tetralogy of Fallot has both short and long-term complications. As is the case with most heart surgeries, the risk of endocarditis is lifelong because the patient now has a prosthetic valve.

Short-term postoperative complications include the following:

  • Rebleeding

  • Tamponade

  • Persistent elevation in right ventricular (RV) pressures

  • Right heart failure

  • Sternal wound infection

  • Atrial arrhythmias

Long-term postoperative complications include the following:

  • Pulmonary valve insufficiency

  • Persistent RV outflow tract obstruction

  • Atrial and ventricular arrhythmias

  • Right heart failure

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