Abstract 18101: Change in Rv Size and Function Over Time By Serial MRI in Repaired Tetralogy of Fallot
Introduction: Adult patients following repair of tetralogy of Fallot (TOF) commonly have significant residual pulmonary incompetence (PI) and a need for late pulmonary valve replacement (PVR). Cardiac MRI (CMR) is considered the gold standard for measurement of right ventricular (RV) size and function. The progression of RV size and function when measured by CMR in this lesion is not well defined. Establishing this is critical to understanding when PVR should be performed.
Hypothesis: We assessed the hypothesis that there would be significant change in RV size and function over time following repaired TOF.
Methods: We determined all adult patients with corrected TOF in whom serial CMRs had been performed over a time period >/= 12 months. Patients were excluded if they had undergone PVR or tricuspid valve intervention in between the two studies. Severity of PI was established by echocardiography and graded as mild, moderate or severe. CMR studies were performed on a GE 1.5T MRI scanner. RV end diastolic volume (RVEDV) and RV ejection fraction (RVEF) were determined using cine- SSFP imaging.
Findings: Thirty patients were identified who met the inclusion criteria. Mean age was 29 +/-8.5 years. PI by echocardiography was mild in 2 patients (6%) moderate in 14 (47%) and severe in 16 (53%). Mean indexed RVEDV at baseline was 154+/-36 mls/m2. Mean RVEF was 41+/-7%. Mean time between the two scans was 4.2+/-2.2 years. Mean percentage change in RVEDV was +1.5%(+/-7.4%). Only 3 patients (10%) had a 10% or greater increase in RVEDV. There was no significant change in the mean RVEDV over the two scans (p=0.35). Mean rate of change of the RVEDV was +0.4%/year (+/-2.4%). Mean change in the RVEF was +1.1% (+/- 3.8%) with a mean change per year of 0.4%(+/-1.3%). There was no significant change in the mean RVEF over the two scans (p=0.15). Severity of PI was not significantly correlated with change in RVEDV (p=0.77) or RVEF (p=0.6).
Conclusions: In conclusion we found a low rate of change in RVEDV and RVEF measured by CMR over time in patients with repaired TOF. This change did not reach statistical significance and was not significantly correlated with degree of PI.
- © 2012 by American Heart Association, Inc.