267: Multiparametric assessment of the Right Ventricle by echography in patients with repaired Tetralogy of Fallot undergoing pulmonary valve replacement: a comparative study with MRI

Abstract

Evaluation of the right ventricle (RV) using echography is challenging in patients with repaired Tetralogy of Fallot (rTOF). The objective of this study was to evaluate the feasibility and the accuracy of a multiparametric echographic approach including 2D strain and 3D for RV volumes and function assessment, in comparison with MRI. we performed an echographic study including 2D TAPSE, S’TDI, Tei indice, Fractional area change (FAC)), 2D strain and 3D, and an MRI in 26 consecutive patients with rTOF before PVR and one year after surgery. TAPSE, S’ TDI and 2D strain parameters were poorly correlated with MRI regarding RV function assessment. FAC was well correlated with REVF before and after PVR (r=0.70, p<0.01and r=0.68, p<0.01, respectively). Despite RV volumes underestimation, 3D analysis was well correlated with MRI values in both pre and post-operative assessment (r=0.88, p<0.01 and r=0.91, p<0.01 respectively for RVEDV; r=0.92, p<0.01 and r=0.95, p<0.01 respectively for RVESV). Global approach of RV function using 2D (FAC) or (3D) parameters seems reliable in patients with rTOF. The commonly used TAPSE and S’TDI focused on segmental analysis of RV inflow are less sensitive probably because RV inflow is less affected by RV remodelling related to initial surgical repair.