Optimal timing for pulmonary valve replacement in adults after tetralogy of Fallot repair

The timing of pulmonary valve replacement in adult patients with repaired tetralogy of Fallot remains controversial. A magnetic resonance imaging study in 17 adult patients with repaired tetralogy of Fallot reveals a statistically significant decrease in right ventricular (RV) volume (RV end-diastolic volume 163 +/- 34 to 107 +/- 26 ml/m(2), p < 0.001; RV end-systolic volume 109 +/- 27 to 69 +/- 22 ml/m(2), p < 0.001) at a mean follow-up of 21 months after pulmonary valve replacement; whereas RV systolic function remained unchanged (mean RV ejection fraction 32 +/- 7 % to 34 10 %, p = 0.12). In no patients with a RV end-diastolic volume > 170 ml/m(2) or a RV end-systolic volume > 85 ml/m(2) before pulmonary valve replacement were RV volumes normalized after surgery. (c) 2005 by Excerpta Medica Inc.