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E2302. Pre- and Post-Operative Evaluation of Tetralogy of Fallot (TOF) on 4D MRI
Authors
  1. Alex Chung; University of California, Los Angeles
  2. Daniel Bradley; University of California, Los Angeles
  3. Arash Bedayat; University of California, Los Angeles
  4. Ashley Prosper; University of California, Los Angeles
Background
- Tetralogy of Fallot (TOF) is the most common congenital cyanotic heart disease that has a wide clinical manifestation with varying surgical techniques for repair with excellent short term results. - It is crucial for the radiologist to be able to identify key relevant anatomical anomalies that can direct surgical planning, expected post-repair findings and potential complications.

Educational Goals / Teaching Points
- Review the combination of structural cardiac anomalies which comprise Tetralogy of Fallot (TOF), which include overriding aorta, ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy with or without atrial septal defect and coronary anomalies. - Overview of the surgical repair of TOF, which include ventricular septal defect closure, right ventricular outflow tract patch, infundibular resection, pulmonary valvuloplasty. - Pre- and post-surgical imaging of TOF. - Case-based review of potential surgical complications.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
- Review the combination of structural cardiac anomalies which comprise Tetralogy of Fallot (TOF), which include overriding aorta, ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy with or without atrial septal defect and coronary anomalies. - Overview of the surgical repair of TOF, which include ventricular septal defect closure, right ventricular outflow tract patch, infundibular resection, pulmonary valvuloplasty. - Pre- and post-surgical imaging of TOF. - Case-based review of potential surgical complications.

Conclusion
- TOF is the most common cyanotic congenital heart disease. - MR imaging is an essential tool for the diagnosis, guiding surgical treatment and post operative follow-up of patients with TOF. - Newer MR techniques including 4D flow and 4D MUSIC are providing additional insight to anatomy and physiology in pre- and post surgical evaluation of these patients. - Steady state FE-MRA is a simple and powerful tool for visualization of the pulmonary vascular network and intracardiac anatomy.