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