title: Evolution of right ventricular size over time after tetralogy of Fallot repair: a longitudinal cardiac magnetic resonance study.
abstract: OBJECTIVE
  It is commonly believed that pulmonary regurgitation (PR) after surgical repair of tetralogy of Fallot (TOF) leads to progressive right ventricular (RV) enlargement. However, progressive RV dilatation has never clearly been documented in this patient population. Therefore, we studied the size of the RV over time in patients after surgical TOF repair.
  
  
  RESULTS
  Fifty-one consecutive patients after surgical TOF repair underwent at least two cardiovascular magnetic resonance (CMR) exams using a single CMR scanner. Patients with RV outflow tract obstruction, interventions other than the initial repair and CMR exams with use of sedation were excluded. Three subgroups with different repair techniques were studied: transannular patch repair [n = 22, age 17 ± 10 years], subvalvular patch repair [n = 15, age 22 ± 8 years], or non-patch repair/infundibulectomy (n = 14, age 28 ± 11 years). Right ventricular end-diastolic volume index (RVEDVI) and PR fraction did not change during the 37 ± 21 months follow-up between first and last CMR in the whole group (RVEDVI: 118 ± 23 mL/m2 vs. 119 ± 23 mL/m2, P = 0.720; PR fraction: 33% (23-40%) vs. 32% (24-39%), P = 0.268). RVEDVI remained stable in all subgroups (transannular patch: 120 ± 21 mL/m2 vs. 122 ± 22 mL/m2, subvalvular patch: 112 ± 23 mL/m2 vs. 111 ± 23 mL/m2, non-patch: 123 ± 28 mL/m2 vs. 123 ± 23 mL/m2, P = 0.827). RVEDVI at last CMR did not differ between groups (P = 0.301).
  
  
  CONCLUSIONS
  This study shows no progression of RV dilatation in patients after surgical repair of TOF with moderately dilated RVs and significant PR during a 3-year follow-up. RV dilatation in our patient group seems to be independent from surgical repair techniques.
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München an der Technischen Universität München, Lazarettstrasse 36, 80636 Munich, Germany.|Division of Cardiology, Centre hospitalier universitaire vaudois, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
authors.forename: Tobias
authors.initials: T
authors.lastname: Rutz
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München an der Technischen Universität München, Lazarettstrasse 36, 80636 Munich, Germany.
authors.forename: Fransis
authors.initials: F
authors.lastname: Ghandour
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München an der Technischen Universität München, Lazarettstrasse 36, 80636 Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Meierhofer
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München an der Technischen Universität München, Lazarettstrasse 36, 80636 Munich, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Naumann
authors.affiliation: Department of Radiology, Deutsches Herzzentrum München an der Technischen Universität München, Lazarettstrasse 36, 80636 Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Martinoff
authors.affiliation: Department of Cardiothoracic Surgery, Deutsches Herzzentrum München an der Technischen Universität München, Lazarettstrasse 36, 80636 Munich, Germany.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Lange
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München an der Technischen Universität München, Lazarettstrasse 36, 80636 Munich, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Ewert
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München an der Technischen Universität München, Lazarettstrasse 36, 80636 Munich, Germany.
authors.forename: Heiko C
authors.initials: HC
authors.lastname: Stern
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München an der Technischen Universität München, Lazarettstrasse 36, 80636 Munich, Germany.
authors.forename: Sohrab
authors.initials: S
authors.lastname: Fratz
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D006348:Cardiac Surgical Procedures / Q000379:methods*; D016009:Chi-Square Distribution; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging* / Q000601:surgery*; D013997:Time Factors; D016278:Ventricular Function, Right / Q000502:physiology*; D020257:Ventricular Remodeling / Q000502:physiology*; D055815:Young Adult
keywords: RV dilatation ; cardiac magnetic resonance; congenital heart disease ; tetralogy of Fallot ; transannular patch 