C-MRI assessment of pulmonary regurgitation in repaired tetralogy of fallot

Abstract

Objective To assess pulmonary regurgitation in repaired tetralogy of fallot (TOF) with cardic MRI (c-MRI) and to analyze the factors related with severe pulmonary regurgitation (PR). Methods Fifty-eight patients who underwent TOF repair from Jan. 1996 to Jun. 2007 were subjected to c-MRI examination for PR fraction (PRF). All cases were divided into two groups according to PRF < 35% and PRF≥35%. SPSS11.5 software was used to analyze the relationship between PRF and the factors including operation age, gender, weight, the procedure of RVOT reconstruction, preoperative NAKATA index, preoperative McGoon index, duration of CPB, aorta clamping, mechanical support, ICU stay and followup, current NAKATA index, current MeGoon index, pulmonary annular index (PAI). Results PRF was (25.9 ±15.2) %. Univariate analysis revealed that the procedure of RVOT reconstruction (P < 0. 05 ), current NAKATA index ( P < 0.01 ), current McGoon index ( P < 0. 01 ), PAl ( P < 0. 05 ) had statistically significant difference. Binary Logistic analysis indicated that current NAKATA index ( P <0. 05 ) and PAI ( P < 0. 01 )were independent factors related with severe PR. Conclusion Severe PR may be correlated with the procedure of transannular enlarging RVOT, currently hypoplastic pulmonary arteries and high PAI. Key words: Pulmonary regurgitation; Tetralogy of fallot; Cardic MRI; Pulmonary valve replacement