Range of ventricular dimensions and function by steady-state free precession cine MRI in repaired tetralogy of fallot: Right ventricular outflow tract patch vs. conduit repair

Abstract

Purpose: To characterize the range of biventricular size and function evaluated by steady-state free precession (SSFP) cine magnetic resonance (MR) in a large cohort of patients with repaired tetralogy of Fallot (TOF), and to compare these measurements in those with a right ventricular outflow tract (RVOT) patch vs. a right ventricle-to-pulmonary artery (RV-PA) conduit. Materials and Methods: Analysis of ventricular size and function in 300 consecutive examinations in patients with repaired TOF evaluated by SSFP cine MR. Results: Of the 300 examinations performed in 256 patients, 69% had undergone repair with a RVOT patch and 31% with a RV-PA conduit. Compared to patients with RV-PA conduit, those with a RVOT patch had significantly more pulmonary regurgitation (PR) (38 ± 17 vs. 23 ± 16%, P < 0.0001), larger indexed RV end-diastolic volume (154 ± 53 vs. 133 ± 51 mL/m2, P = 0.002), similar indexed end-systolic volume (80 ± 39 vs. 74 ± 46 mL/m2, P = 0.31), higher ejection fraction (EF) (50 ± 9 vs. 47 ± 12%, P = 0.037), and lower mass-to-volume ratio (0.29 ± 0.08 vs. 0.36 ± 0.13, P < 0.0001). Pulmonary regurgitation fraction correlated positively with RV end-diastolic volume index in the RVOT patch group (r = 0.51, P < 0.0001) but not in the RV-PA conduit. Conclusion: This study provides the range and distribution of biventricular size and function, and PR measured by MRI In a large contemporary cohort of patients with repaired TOF, and demonstrates important variations in RV mechanics between patients repaired with a RVOT patch and those with an RV-PA conduit. © 2007 Wiley-Liss, Inc.