[01] Abla Ali Ahmed, Department of cardiology, Faculty of medicine, Ain Shams University, Cairo, Egypt. [02] Yasmin Abdelrazek Ali, Department of cardiology, Faculty of medicine, Ain Shams University, Cairo, Egypt. [03] Hebattallah Mohamed Attia, Department of cardiology, Faculty of medicine, Ain Shams University, Cairo, Egypt. [04] Azza Abdallah El Fiky, Department of cardiology, Faculty of medicine, Ain Shams University, Cairo, Egypt. [05] Maiy Hamdy El Sayed, Department of cardiology, Faculty of medicine, Ain Shams University, Cairo, Egypt.

Background: Tetralogy of Fallot is the most common form of cyanotic CHD. Surgical repair of TOF may be followed by various residual findings. CMR (Cardiac magnetic resonance) is the gold standard for evaluation of right ventricle (RV) volumes and quantification of degree of pulmonary regurgitation, meanwhile echocardiography represents the main line of follow up of these patients. Methods: This was a cross sectional observational study including 50 patients after TOF repair, presented to Ain Shams University Hospital for follow up, over 24 months. Transthoracic echocardiography (TTE) examination was done for RV linear diameters, RV function by fractional area change (FAC), tricuspid annulus plane systolic excursion (TAPSE), RV longitudinal strain, pulmonary regurgitation (PR) by diastolic flow reversal grading, Deceleration time (DT), PR jet width / pulmonary valve (PV) annulus ratio, and PR index (Time duration of PR/total diastole time) and full cardiac magnetic resonance for ten patients; measuring RV volumes, RV ejection fraction (EF) and PR fraction. Results: The study included 50 patients post TOF surgical repair, 26 (52%) males and 24 (48%) females, with a mean age of 11.88 years. Mean RV FAC by TTE was 51%, TAPSE mean value was 15, and mean GLS of RV was -19. The residual peak PG across the RVOT mean value was 35mmHg. Thirty-two of our patients (64%) had severe PR by diastolic flow reversal, fourteen patients (28%) had moderate to severe PR, and four patients (8%) had moderate PR. In the ten patients who had CMR, the mean RVEF was 50%, and the PR fraction mean value was 54%. There was a strong correlation between the RV diameters measured by TTE and RV volumes measured by CMR, accordingly a regression analysis equation to calculate RV volumes from a given RV diameter measured by TTE can be done. Conclusion: The follow up post TOF repair should be directed towards early and accurate assessment of post repair sequel and defining the intervention threshold. Multimodality imaging provides more accurate and practical protocol. The echocardiographic assessment can be used as a triage to decide who will benefit from expensive and not readily available CMR.

Fallot Tetralogy, Right Ventricle, Pulmonary Regurgitation, Cardiac Magnetic Resonance Imaging

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