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Tetralogy of Fallot

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Magnetic Resonance Imaging of Congenital Heart Disease

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Abstract

Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease, occurring in 1 in 3,600 live births [1]. Complete repair of TOF was devised over 50 years ago (first reported by Lillehei in 1954) and can result in complete intra-cardiac repair in early infancy [2]. However, despite excellent short- and medium-term survival rates, the 30 year actuarial survival for patients repaired before their 5th birthday is 90 % of the expected survival rate and the annualized risk of death triples in the third postoperative decade [2, 3]. Late morbidity and mortality, in particular related to pulmonary incompetence, has been observed in many patients long after total repair.

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Author information

Authors and Affiliations

  1. Academic Clinical Fellow, Pediatric Cardiology, Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Sciences and Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK

    Michael A. Quail MB ChB

  2. UCL Centre for Cardiovascular MR, University College London, 30 Guildford Street, London, WC1N 1EH, UK

    Vivek Muthurangu M.D., MRCPCH

  3. Cardio-Respiratory Unit, UCL Institute of Child Health and Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK

    Andrew M. Taylor M.D., FRCR, FRCP

Authors
  1. Michael A. Quail MB ChB
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  2. Vivek Muthurangu M.D., MRCPCH
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  3. Andrew M. Taylor M.D., FRCR, FRCP
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Corresponding author

Correspondence to Michael A. Quail MB ChB .

Editor information

Editors and Affiliations

  1. , Stritch School of Medicine, Loyola University Chicago, S. First Ave. 2160, Maywood, 60153, Illinois, USA

    Mushabbar A. Syed

  2. Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom

    Raad H. Mohiaddin

7.1 Electronic Supplementary Material

Below is the link to the electronic supplementary material.

3D volume rendered MR angiogram of the RA, RV, pulmonary trunk and branch pulmonary arteries, viewed from the front and then rotated along the horizontal axis. Note the kinked, narrowed origin of the left pulmonary artery(MOV 473 KB)

Balanced SSFP oblique sagittal cine through the RVOT and pulmonary trunk. Note the dilated, but contractile RVOT, dilated pulmonary trunk and free pulmonary incompetence (signal loss during diastole in the RV) (MOV 124 KB)

Four, balanced SSFP short axis cine images from base to apex, showing a pressure-overloaded RV (delayed RV emptying and septal flattening) with a marked dilated LV, with lateral wall akinesia. The patient had severe RV to pulmonary trunk conduit stenosis and a lateral wall infarction secondary to left circumflex artery damage at the time of surgery (MOV 1628 KB)

Volume rendered 4D CT, view from left posterior oblique, showing the dynamic nature of the RVOT and pulmonary trunk in a patient with a RVOT patch repair in infancy and chronic free pulmonary incompetence. Note the position of the left anterior descending coronary artery (MP4 166 KB)

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Quail, M.A., Muthurangu, V., Taylor, A.M. (2012). Tetralogy of Fallot. In: Syed, M., Mohiaddin, R. (eds) Magnetic Resonance Imaging of Congenital Heart Disease. Springer, London. https://doi.org/10.1007/978-1-4471-4267-6_7

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  • DOI: https://doi.org/10.1007/978-1-4471-4267-6_7

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  • Print ISBN: 978-1-4471-4266-9

  • Online ISBN: 978-1-4471-4267-6

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