Abstract 16434: Repaired Tetralogy of Fallot With Coexisting Unrepaired Partial Anomalous Pulmonary Venous Connection is Associated With Diminished Right Ventricular Ejection Fraction and More Severe Right Ventricular Dilation
Introduction: There is a known association between Tetrology of Fallot (ToF) and partial anomalous pulmonary venous connection (PAPVC).
Hypothesis: We hypothesize that patients with ToF and PAPVC have diminished right ventricular ejection fraction (RVEF) in comparison to ToF patients without PAPVC.
Methods: We reviewed all cardiac magnetic resonance imaging (CMR) at our institution for ToF from 1/1/2004 to 5/1/2014. We included patients with repaired ToF and unrepaired PAPVC. We used sex and age matched repaired ToF patients without PAPVC as controls. We performed comparative statistics to find differences between the groups.
Results: There were 9 patients with repaired ToF and unrepaired PAPVC and 18 controls. In all 9 cases, the PAPVC was not detected on preoperative echocardiography. There were no significant differences in surgical course and body surface area between the two groups (Table 1). Repaired ToF patients with unrepaired PAPVC showed significantly higher indexed RVEDV, RV to LV size ratios and a higher incidence of reduced RVEF compared to controls (Table 1). There were three pediatric patients with reduced RVEF (range 3 months to 16 years) which normalized on echocardiography after returning to the operating room for PAPVC repair. One of these patients had their RV function measured with CMR after PAPVC repair (Figure 1).
Conclusions: Repaired ToF with unrepaired PAPVC is associated with reduced RVEF and more significant RV dilation. Therefore, it is important to assess for PAPVC in repaired ToF patients with reduced RVEF and disproportionate RV dilation.
Author Disclosures: S.S. Chan: Research Grant; Modest; GE research grant for digital tomosynthesis. Other; Modest; Provisional patent for novel quantification method for Spectral Doppler ultrasound. K.K. Whitehead: None. T.S. Kim: None. G.L. Fu: None. M.S. Keller: None. M.A. Fogel: None. M.A. Harris: None.
- © 2014 by American Heart Association, Inc.