title: Time course of right ventricular functional parameters after surgical correction of tetralogy of Fallot determined by cardiac magnetic resonance.
abstract: OBJECTIVE
  To evaluate changes of right ventricular (RV) parameters in follow-up examinations after corrected tetralogy of Fallot (TOF) by cardiac magnetic resonance (CMR).
  
  
  METHODS
  CMR was performed twice within 4 years in 45 patients using a 1.5 T scanner. RV-volumes and pulmonary-regurgitant-fractions (PRF) were calculated from standard cine-sequences and flow-sensitive gradient-echo images, respectively. Patients were divided into two groups depending on the post-operative (po) interval (group 1 ≤5 years po; group 2 >5 years po) and subgroups depending on type of surgery (transannular vs. non-transannular). Patient groups were compared among each other and differences between 1st and 2nd CMR were assessed. Furthermore, patients were compared with 25 healthy volunteers.
  
  
  RESULTS
  Compared with controls RV-size was increased (group 1: p = 0.007; group 2: p < 0.001) and RV function decreased (group 1: p = 0.02; group 2: p < 0.001) in po TOF-patients. PRF was higher in group 2 compared with group 1 (p = 0.04) and significant changes of PRF between 1st and 2nd CMR were found in group 2 (p < 0.01), but not in group 1 (p = 0.29). Compared with the non-transannular subgroup, PRF (p < 0.001) and RV end-diastolic-volume index (RV-EDVI) (p = 0.03) were significantly higher in patients with a transannular patch, EDVI increased between 1st and 2nd CMR. After correction, no significant changes of RV myocardial mass index (RV-MMI) were found.
  
  
  CONCLUSIONS
  After correction of TOF, RV-size, RV-muscle mass (RV-MM) was increased and ejection fraction decreased in "early" follow-up already. Whereas these parameters can remain stable over a long time period, the PRF significantly increased in "late" follow-up dependent on the po interval. Overall, transannular patching went along with higher PRF and bigger RV-size as well as a greater dynamic of these parameters in the time course, which makes this subgroup highly in need of regular follow-up examinations for the optimal timing of re-interventions. In contrast, the increased RV-MM demonstrated no regression po.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Leipzig-Heart Center, Strümpellstrasse 39, Leipzig, Germany. matthias.grothoff@herzzentrum-leipzig.de
authors.forename: M
authors.initials: M
authors.lastname: Grothoff
authors.forename: J
authors.initials: J
authors.lastname: Hoffmann
authors.forename: L
authors.initials: L
authors.lastname: Lehmkuhl
authors.forename: H
authors.initials: H
authors.lastname: Abdul-Khaliq
authors.forename: S
authors.initials: S
authors.lastname: Nitzsche
authors.forename: A
authors.initials: A
authors.lastname: Mahler
authors.forename: I
authors.initials: I
authors.lastname: Dähnert
authors.forename: F
authors.initials: F
authors.lastname: Berger
authors.forename: M
authors.initials: M
authors.lastname: Gutberlet
mesh_terms: D002306:Cardiac Volume; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011665:Pulmonary Valve Insufficiency; D012189:Retrospective Studies; D013771:Tetralogy of Fallot / Q000503:physiopathology* / Q000601:surgery*; D013997:Time Factors; D016278:Ventricular Function, Right / Q000502:physiology*; D055815:Young Adult