Early to Mid-Term Cardiac Magnetic Resonance Findings after Transcatheter Pulmonary Valve Replacement in Patients with Repaired Tetralogy of Fallot
TL;DR
The results suggest that although RV volumes decreased—with normalization in one-third of the cases—there was no significant improvement in RV function, and regular follow-up with CMR imaging is recommended.
Abstract
: Background: Cardiac magnetic resonance (CMR) imaging following transcatheter pulmonary valve replacement (TPVR) allows for the assessment of right ventricular (RV) volume. This study aimed to evaluate early-to mid-term findings after the procedure. Methods: A total of 21 patients with repaired tetralogy of Fallot who underwent TPVR were enrolled in the study. CMR data before and after the procedure were compared. The median interval between the procedure and the post-TPVR CMR was 9 months (range: 6–18 months). Results: RV volumes and RV end-diastolic volume indices were significantly lower after TPVR compared to before the procedure. RV volume parameters returned to normal limits in only one-third of the patients. There were no significant differences in left ventricular volume parameters or in RV ejection fraction between the pre-and post-TPVR imaging. Additionally, the distal diameters of the left and right pulmonary arteries were significantly greater after TPVR than before. A moderate positive correlation was found between the time elapsed from TPVR to CMR imaging and RV volumes. Furthermore, there was a moderate positive correlation between age and aortic root diameter. Conclusions: Our results suggest that although RV volumes decreased—with normalization in one-third of the cases—there was no significant improvement in RV function. As RV volumes tend to increase again over time, regular follow-up with CMR imaging is recommended.