Medical Emergencies · single question
A child with history of tetralogy of Fallot (TOF) repaired in childhood presents for dental care. Which prophylaxis consideration applies?
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Correct answer: D. Requires prophylaxis — consult cardiologist first
Tetralogy of Fallot is a complex congenital heart defect. After complete surgical repair, the AHA 2007 guidelines state that antibiotic prophylaxis is NOT required after 6 months post-repair IF there are no residual defects. However, if there are residual defects at the patch site, prophylaxis IS required. Because TOF repair is complex and individual patients may have residual shunts/defects, the correct INBDE approach is to consult the cardiologist first before determining prophylaxis need.
- A. ❌ Not all repaired TOF patients require prophylaxis — it depends on whether residual defects exist.
- B. ❌ The '6 months post-repair no prophylaxis' rule applies only when repair is COMPLETE with no residual defects — which requires cardiologist confirmation.
- C. ❌ This oversimplifies the situation — TOF can have residual defects requiring ongoing prophylaxis.
- D. ✅ CORRECT – The safest approach: consult the cardiologist before determining prophylaxis need, as residual defects may still require it.
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