What are the AHA/ACC treatment guidelines for tetralogy of Fallot (TOF) in adults?

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

Pulmonary valve replacement (surgical or percutaneous) for symptomatic relief is recommended for patients with repaired tetralolgy of Fallot and moderate or greater pulmonary regurgitation (PR) with otherwise unexplained cardiovascular symptoms.

Pulmonary valve replacement (surgical or percutaneous) is reasonable for preservation of ventricular size and function in asymptomatic patients with repaired tetralogy of Fallot and ventricular enlargement or dysfunction and moderate or greater PR.

Primary prevention with implantable cardioverter-defibrillator (ICD) therapy is reasonable in adults with tetralogy of Fallot and multiple risk factors for SCD.

Surgical pulmonary valve replacement may be reasonable for adults with repaired tetralogy of Fallot and moderate or greater PR with other lesions that require surgical interventions.

Consider pulmonary valve replacement, in addition to arrhythmia management, for adults with repaired tetralogy of Fallot and moderate or greater PR and ventricular tachyarrhythmia.


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