Progressive right ventriculair dilatation after repair of tetralogy of Fallot: myth or reality? A single center evaluation by repeat cardiovascular magnetic resonance over 37 months

T. Rutz; S. Naumann; F. Ghandour; C. Meierhofer; S. Martinoff; P. Ewert; H. C. Stern; S. Fratz

doi:10.1055/s-0034-1394035

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Thorac Cardiovasc Surg 2014; 62 - p12
DOI: 10.1055/s-0034-1394035

Progressive right ventriculair dilatation after repair of tetralogy of Fallot: myth or reality? A single center evaluation by repeat cardiovascular magnetic resonance over 37 months

T. Rutz ¹^,², S. Naumann ¹, F. Ghandour ¹, C. Meierhofer ¹, S. Martinoff ³, P. Ewert ¹, H. C. Stern ¹, S. Fratz ¹

¹Klinik für Kinderkardiologie und angeborene Herzerkrankungen, Deutsches Herzzentrum München an der Technischen Universität München, München
²Service de Cardiologie, Centre hospitalier universitaire vaudois, Lausanne
³Klinik für Radiologie, Deutsches Herzzentrum München an der Technischen Universität München, München

Congress Abstract

Aim: The study evaluates in patients with tetralogy of Fallot (TOF) the impact of surgical repair with and without transannular patch on pulmonary regurgitation (PR) and right ventricular (RV) dilatation over time.

Methods: In 51 patients without RV outflow tract stenosis RV and left ventricular (LV) volumes and PR fraction were measured by two cardiac magnetic resonance (CMR) exams. Patients after transannular patch repair (TR, n=22), subvalvular patch repair (SR, n=15) and repair with infundibulectomy (IN, n=14) were compared.

Results: Time between CMR exams did not differ between groups: TR 37±20 vs. SR 37±19 vs. IN 37±25 months, p=0.998. RV enddiastolic volume index (RVEDVI) and PR did not change significantly in the whole group: RVEDVI (ml/m²): 118±23 vs. 119±23, p=0.684. PR (%): 32±11 vs. 32±11, p=0.772. RVEDVI at last CMR and change of RVEDVI did not differ between groups: RVEDVI (ml/m²): TR 122±22 vs. SR 111±23 vs. IN 123±25, p=0.301; change RVEDVI (ml/m²): TR 2.3±16 vs. SR -0.8±9.8 vs. IN 0.5±20, p=0.162.

Multivariate analysis revealed RVEDVI and RV endsystolic volume index (RVESVI) having a significant impact on RVEDVI change (ml/m²): RVEDVI β=-0.680, p=0.006; RVESVI β=0.543, p=0.021.

Conclusions: Progression of RV dilatation in patients after TOF repair with moderately dilated RV is slow. Valve sparing repair does not preclude from RV dilatation.