RACHS score

###RACHS - Risk adjustment for congenital heart surgery

Individual procedures by risk category

##### Risk category 1 - Atrial septal defect surgery (including atrial septal defect secundum, sinus venosus atrial septal defect, *patent foramen ovale closure) - Aortopexy - Patent ductus arteriosus surgery at age >30 d - Coarctation repair at age >30 d - Partially anomalous pulmonary venous connection surgery ##### Risk category 2 - Aortic valvotomy or valvuloplasty at age >30 d - Subaortic stenosis resection - Pulmonary valvotomy or valvuloplasty - Pulmonary valve replacement - Right ventricular infundibulectomy - Pulmonary outflow tract augmentation - Repair of coronary artery fistula - Atrial septal defect and ventricular septal defect repair - Atrial septal defect primum repair - Ventricular septal defect repair - Ventricular septal defect closure and pulmonary valvotomy or infundibular resection - Ventricular septal defect closure and pulmonary artery band removal - Repair of unspecified septal defect - Total repair of tetralogy of Fallot - Repair of total anomalous pulmonary veins at age >30 d - Glenn shunt - Vascular ring surgery - Repair of aorta-pulmonary window - Coarctation repair at age ≤30 d - Repair of pulmonary artery stenosis - Transection of pulmonary artery - Common atrium closure - Left ventricular to right atrial shunt repair ##### Risk category 3 - Aortic valve replacement - Ross procedure - Left ventricular outflow tract patch - Ventriculomyotomy - Aortoplasty - Mitral valvotomy or valvuloplasty - Mitral valve replacement - Valvectomy of tricuspid valve - Tricuspid valvotomy or valvuloplasty - Tricuspid valve replacement - Tricuspid valve repositioning for Ebstein anomaly at age >30 d - Repair of anomalous coronary artery without intrapulmonary tunnel - Repair of anomalous coronary artery with intrapulmonary tunnel (Takeuchi) - Closure of semilunar valve, aortic or pulmonary - Right ventricular to pulmonary artery conduit - Left ventricular to pulmonary artery conduit - Repair of double-outlet right ventricle with or without repair of right ventricular obstruction - Fontan procedure - Repair of transitional or complete atrioventricular canal with or without valve replacement - Pulmonary artery banding - Repair of tetralogy of Fallot with pulmonary atresia - Repair of cor triatriatum - Systemic to pulmonary artery shunt - Atrial switch operation - Arterial switch operation - Reimplantation of anomalous pulmonary artery - Annuloplasty - Repair of coarctation and ventricular septal defect closure - Excision of intracardiac tumor ##### Risk category 4 - Aortic valvotomy or valvuloplasty at age ≤30 d - Konno procedure - Repair of complex anomaly (single ventricle) by ventricular septal defect enlargement - Repair of total anomalous pulmonary veins at age ≤30 d - Atrial septectomy - Repair of transposition, ventricular septal defect, and subpulmonary stenosis (Rastelli) - Atrial switch operation with ventricular septal defect closure - Atrial switch operation with repair of subpulmonary stenosis - Arterial switch operation with pulmonary artery band removal - Arterial switch operation with ventricular septal defect closure - Arterial switch operation with repair of subpulmonary stenosis - Repair of truncus arteriosus - Repair of hypoplastic or interrupted arch without ventricular septal defect closure - Repair of hypoplastic or interrupted aortic arch with ventricular septal defect closure - Transverse arch graft - Unifocalization for tetralogy of Fallot and pulmonary atresia - Double switch ##### Risk category 5 - Tricuspid valve repositioning for neonatal Ebstein anomaly at age ≤30 d - Repair of truncus arteriosus and interrupted arch ##### Risk category 6 - Stage 1 repair of hypoplastic left heart syndrome (Norwood operation) - Stage 1 repair of nonhypoplastic left heart syndrome conditions - Damus-Kaye-Stansel procedure
Jenkins *et al.*, **Consensus-based method for risk adjustment for surgery for congenital heart disease.** *J. Thorac.*, Jan 2002, 123(1), 110-118