Tetralogy of Fallot Repair

Also known as: TOF repair, corrective repair of tetralogy of Fallot.

What is tetralogy of Fallot repair?

Tetralogy of Fallot (TOF) is a heart defect present at birth. TOF consists of four different heart abnormalities:

  • a ventricular septal defect (which is a hole between both ventricles in the heart)
  • overriding aorta (which is the major blood vessel in the heart that carries oxygenated blood to the body, lies on top of both ventricles instead of the left ventricle)
  • pulmonary stenosis (a narrowing around or at the pulmonary valve limiting the amount of blood that goes into the lungs)
  • right ventricular hypertrophy (right ventricle becomes thicker because of the increase amount of work has to perform in order to get the blood into the lungs).
TOF repair is a surgery that corrects these defects.

What happens during the procedure?

TOF repair is an open-heart surgery in which the surgeon makes an incision in front of the chest and opens the breastbone in order to operate directly on the heart. Your child is then placed on a heart and lung machine called cardiopulmonary bypass in order to perform the surgery. The surgeon will widen or augment via a patch the flow of blood to the pulmonary blood vessels and the pulmonary valve; he will also cut away the muscle tissue in the right ventricle which was restricting the blood flow from the right ventricle to the pulmonary artery to enhance blood flow. Then the ventricular septal defect (VSD) is closed by sewing a patch over the hole inside the heart.

Is any special preparation needed?

TOF repair requires general anesthesia to be performed, which means that your child will be asleep during the surgery. The child will need to avoid foods, drinks and certain medications, if taking any, for a period of time before the procedure.

What are the risk factors?

Possible complications after the procedure include abnormal heart rhythms, leaky heart valves, diminished heart function, the possibility of some of the problems recurring requiring interventions such as cardiac catheterization or surgery and other risks. Consistent monitoring and long term follow up of patients is essential after TOF repair.

Over Two Decades of Experience in TOF Repair

Tetralogy of Fallot repair is performed by Nicklaus Children’s Hospital’s Heart Institute team of top-notch pediatric heart surgeons using the latest cutting edge techniques. Surgical results are among the very best reported, with extremely low mortality, short length of stay and a low incidence of morbidity.


Reviewed by: Darline Santana-Acosta, MD

This page was last updated on: April 30, 2021 09:24 AM

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Repair of Tetralogy of Fallot in Nearly 400 patients, a Single Center Experience: 1995-2019

May 22, 2019 – The Heart Institute at Nicklaus Children’s Hospital remains dedicated to providing the very best and safest experience for patients undergoing congenital heart surgery. This report will review the program’s 24-year surgical experience in repairing children with a diagnosis of tetralogy of Fallot (TOF).