BIVENTRICULAR SYSTOLIC - FUNCTION AND MASS STUDIED WITH MR-IMAGING INCHILDREN WITH PULMONARY REGURGITATION AFTER REPAIR FOR TETRALOGY OF FALLOT

PURPOSE: To study biventricular systolic function and mass of the hear t in young patients with residual pulmonary regurgitation who had unde rgone surgical correction of tetralogy of Fallot. MATERIALS AND METHOD S: Transverse gradient-echo magnetic resonance (MR) images covering bo th ventricles were obtained in 19 patients who had undergone correctiv e surgery for tetralogy of Fallot at the age of 1.5 years +/- 1 and in 12 age-matched control subjects. In addition, MR velocity maps of the pulmonary artery were obtained. Biventricular volumes, ejection fract ion and myocardial mass, and pulmonary flow volumes were measured. Exe rcise tests were performed in 17 patients. RESULTS: The right ventricu lar ejection fraction was lower (P < .001) and the right ventricular m ass was higher (P < .0005) in patients than in control subjects; the l eft ventricular ejection fraction was lower (P < .0005) in patients an d correlated statistically significantly with pulmonary regurgitation (r = -.68; P < .005). Exercise performance Inversely correlated with p ulmonary regurgitation (tau = -0.5; P = .01). CONCLUSION: In children who undergo early surgical repair of tetralogy of Fallot residual pulm onary regurgitation correlates with biventricular systolic dysfunction and diminished exercise capacity. Despite successful surgical correct ion, right ventricular hypertrophy may persist.