title: To uncover what is unknown or forgotten - cardiac magnetic resonance in the identification of vascular pathologies in patients after tetralogy of Fallot repair.
abstract: BACKGROUND
  In patients with repaired tetralogy of Fallot (TOF), various pathologies of the vascular system (both arterial and venous) may be present as a result of the previous therapeutic procedures or due to the congenital disease itself. Because of the limited diagnostic capabilities in the past, lacking surgical reports of patients operated on several decades ago and/or a long time since a corrective procedure, some of these pathologies/anomalies may remain unknown.
  
  
  OBJECTIVE
  To identify selected vascular pathologies with the use of cardiac magnetic resonance in patients after TOF repair.
  
  
  METHODS
  We included 208 consecutive patients (median age 24.9 years, interquartile range 20.5-36.7; 126 (60.6%) males) with repaired TOF undergoing cardiac magnetic resonance (CMR) imaging.
  
  
  RESULTS
  Significant unexpected vascular pathologies/anomalies were found in 30 patients (14.4%) and included: uni- or bilateral occlusion of the subclavian artery (n = 20), persistent left superior vena cava (n = 7, in 1 case draining into the left atrium), occluded subclavian vein (n = 1), and interruption of the inferior vena cava (n = 2). Additionally, 1 patient with the left subclavian artery occluded had an occlusion of the brachiocephalic vein. In none of the patients was the information about the uncovered pathology/anomaly present either in the referral information or in the present medical history.
  
  
  CONCLUSIONS
  The CMR in patients with repaired TOF may uncover some pathologies/anomalies which were unknown or forgotten at the time of patients' referral for the study, and which may have a significant impact on patient management.
authors: Magnetic Resonance Unit, Department of Radiology, Institute of Cardiology, Warsaw, Poland ; Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland.
authors: Mateusz
authors: M
authors: Spiewak
authors: Magnetic Resonance Unit, Department of Radiology, Institute of Cardiology, Warsaw, Poland ; Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland.
authors: Lukasz A
authors: LA
authors: Małek
authors: Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland.
authors: Elżbieta K
authors: EK
authors: Biernacka
authors: Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland.
authors: Mirosław
authors: M
authors: Kowalski
authors: Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland.
authors: Piotr
authors: P
authors: Hoffman
authors: Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland.
authors: Marcin
authors: M
authors: Demkow
authors: Magnetic Resonance Unit, Department of Radiology, Institute of Cardiology, Warsaw, Poland.
authors: Jolanta
authors: J
authors: Miśko
authors: Institute of Cardiology, Warsaw, Poland.
authors: Witold
authors: W
authors: Rużyłło
authors: Magnetic Resonance Unit, Department of Radiology, Institute of Cardiology, Warsaw, Poland.
authors: Magdalena
authors: M
authors: Marczak
keywords: Blalock-Taussig shunt; cardiac magnetic resonance; interruption of the inferior vena cava; persistent left superior vena cava; subclavian artery occlusion; tetralogy of Fallot