Three-dimensional left ventricular torsion after pulmonary valve replacement in repaired tetralogy of Fallot: motion tracking analysis

In patients with repaired tetralogy of Fallot (TOF), pulmonary regurgitation is a frequent complication, resulting in right heart failure. Pulmonary valve replacement (PVR) should be performed before irreversible heart failure occurs. Pulmonary regurgitation disappears and RV volume decreases with PVR. Interventricular interactions are expected to improve left ventricular (LV) function, but in some cases LV function is not restored. We analyzed pre- and post-PVR cine cardiac MRI (CMR) with a motion tracking technique to quantitatively assess LV deformity in three dimensions. As a result, a decrease in preoperative LV torsion was a useful predictor of postoperative worsening LV function.