Multimodality imaging of adult patients with surgically corrected tetralogy of Fallot Results from the CSONGRAD Registry

Introduction: There is an increasing ratio of surviving patients with congenital heart disease including tetralogy of Fallot.Objective: The aim of the present study was a comparative assessment of echocardiographic and cardiac magnetic resonance imaging-derived findings in patients with tetralogy of Fallot following early total reconstruction versus early palliation/late correction. Methods: The study comprised 17 patients with tetralogy of Fallot (mean age: 28.6 & PLUSMN; 10.4 years; 10 males). Early total reconstruction was performed in 10 cases (mean age: 25.0 & PLUSMN; 8.0 years; 8 males), while early palliation/late construction was done in 7 subjects (mean age: 33.7 & PLUSMN; 11.8 years; 2 males). Complete two-dimensional Doppler echocardiography and cardiac resonance imaging were performed in all patients. Results: During long-term follow-up, lower left ventricular end-systolic (40.50 & PLUSMN; 10.55 ml/m2 vs. 58.14 & PLUSMN; 19.07 ml/m2, p = 0.013) and end-diastolic volume indices (86.60 & PLUSMN; 12.62 ml/m2 vs. 116.70 & PLUSMN; 23.70 ml/m2, p = 0.002) and stroke volume index (46.00 & PLUSMN; 6.77 ml/m2 vs. 58.43 & PLUSMN; 7.11 ml/m2, p = 0.001) could be detected, which were associated with higher echocardiographic left ventricular ejection fraction (69.75 & PLUSMN; 6.80% vs. 61.67 & PLUSMN; 8.80%, p = 0.038) in patients with tetralogy of Fallot following early total reconstruction as compared to that of subjects late after early palliation/late correction. In regard with the right heart, larger right ventricular muscle mass (72.33 & PLUSMN; 21.03 g/m2 vs. 51.33 & PLUSMN; 22.33 g/m2, p = 0.044) could be seen in patients with tetralogy of Fallot following early total re-construction. Conclusion: Beneficial left ventricular morphological and functional parameters, but more pronounced right ven-tricular hypertrophy could be detected in patients with tetralogy of Fallot following early total reconstruction as compared to that of subjects late after early palliation/late correction.