An Educational and Illustrative Case Report of Late Complications Following Repair of Tetrology of Fallot.
Severe Pulmonary Regurgitation (PR) and its impact on the Right Ventricle (RV) are recognized late complications of repaired cases of Tetralogy of Fallot (TOF). Relief of Right Ventricular Outflow Tract (RVOT) obstruction by transannular patching or infundibulectomy resulted in obligate pulmonary regurgitation in early surgical era. We present classic echocardiographic findings of severe pulmonary regurgitation and right ventricular enlargement in an adult patient aged 50 years who underwent a surgical correction of TOF when he was 10 years old.
The chronic severe pulmonary regurgitation made its impact with severe enlargement of right ventricle with associated systolic dysfunction. The Electrocardiography (EKG) shows a right bundle branch block with a very wide QRS duration of 198 ms underscoring the right ventricular cardiomyopathy. Image 1B, Video 2: is remarkable for massive enlargement and hypokinesis of right ventricle with septal flattening secondary to volume overload due to severe pulmonary regurgitation. Image 1D: A continuous Doppler interrogation across the pulmonary valve shows the classic sine wave pattern of inflow and regurgitation across pulmonary valve with steep deceleration of pulmonary regurgitant waveform, characteristic of severe pulmonary regurgitation.
Heart Res Open J. 2015; 2(4): 115-117. doi: 10.17140/HROJ-2-120