Mid-term follow-up of pulmonary regurgitation in repaired asymptomatic TOF patients by transannular patch: A prospective cardiac MRI study

Objective The long-term outcome of Tetralogy of Fallot (TOF) surgical repair in developing countries is still unknown. Therefore the aim of the study was the quantification of pulmonary regurgitation (PR) and right ventricular functions using cardiac magnetic resonance (CMR) in order to follow up midterm post transannular patch repair of asymptomatic TOF patients. Methods We prospectively studied 37 asymptomatic corrected TOF patients (aged 18 years or less), aged at surgery was of median, min/max of (19, 8/48 months). Cardiac functions were assessed using routine steady state free precession techniques. PR quantification was performed using the routine velocity encoding phase contrast in the main pulmonary artery. Results Four patients had mild PR, 26 had moderate PR and seven had severe PR, with a median value of PR% in CMR amounting to 29% (max: 75% and min: 13%). Indexed right ventricle end-diastolic volume amounted to (mean ± SD) 130 ± 38 ml, and indexed right ventricle end-systolic volume amounted to 63 ± 26 ml. Conclusion Accurate quantitative assessment of PR in the mid and long-term course of TOF patients is paramount. CMR has to be introduced as a new modality in Egypt in the follow up course of asymptomatic TOF patients.