Category: Cyanotic, normal heart size, ↓ pulmonary vascularity
Most common cyanotic congenital heart lesion
Hemodynamics: Obstruction to pulmonary blood flow via infundibular narrowing by anterior deviation of subpulmonary conal septum
Spectrum: Classic "blue tet," "pink tet," TOF with pulmonary atresia & major aortopulmonary collaterals (MAPCAs), TOF with absent pulmonary valve
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Echocardiographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Koppel CJ et al: Coronary anomalies in tetralogy of Fallot - a meta-analysis. Int J Cardiol. 306:78-85, 2020
Li VW et al: Ventricular myocardial deformation imaging of patients with repaired tetralogy of Fallot. J Am Soc Echocardiogr. 33(7):788-801, 2020
Mohamed I et al: Assessment of disease progression in patients with repaired tetralogy of Fallot using cardiac magnetic resonance imaging: a systematic review. Heart Lung Circ. 29(11):1613-20, 2020
Ojha V et al: Spectrum of changes on cardiac magnetic resonance in repaired tetralogy of Fallot: imaging according to surgical considerations. Clin Imaging. 69:102-14, 2020
Rizk J et al: Magnetic resonance imaging risk factors for ventricular arrhythmias in tetralogy of Fallot. Pediatr Cardiol. 41(5):862-8, 2020
Tous C et al: Ex vivo cardiovascular magnetic resonance diffusion weighted imaging in congenital heart disease, an insight into the microstructures of tetralogy of Fallot, biventricular and univentricular systemic right ventricle. J Cardiovasc Magn Reson. 22(1):69, 2020
Apostolopoulou SC et al: Cardiovascular imaging approach in pre and postoperative tetralogy of Fallot. BMC Cardiovasc Disord. 19(1):7, 2019
Egbe AC et al: Coronary artery disease in adults with tetralogy of Fallot. Congenit Heart Dis. 14(3):491-7, 2019
Leonardi B et al: The role of 3D imaging in the follow-up of patients with repaired tetralogy of Fallot. Eur Rev Med Pharmacol Sci. 23(4):1698-709, 2019
Larios G et al: Imaging in repaired tetralogy of Fallot with a focus on recent advances in echocardiography. Curr Opin Cardiol. 32(5):490-502, 2017
Lapierre C et al: Tetralogy of Fallot: preoperative assessment with MR and CT imaging. Diagn Interv Imaging. 97(5):531-41, 2016
Shin YR et al: Factors associated with progression of right ventricular enlargement and dysfunction after repair of tetralogy of Fallot based on serial cardiac magnetic resonance imaging. Eur J Cardiothorac Surg. 50(3):464-9, 2016
Vaujois L et al: Imaging of postoperative tetralogy of Fallot repair. Diagn Interv Imaging. 97(5):549-60, 2016
Wijesekera VA et al: Sequential right and left ventricular assessment in posttetralogy of Fallot patients with significant pulmonary regurgitation. Congenit Heart Dis. 11(6):606-14, 2016
Chan FP et al: Computed tomography and magnetic resonance imaging in neonates with congenital cardiovascular disease. Semin Ultrasound CT MR. 36(2):146-60, 2015
Preim U et al: Delayed enhancement imaging in a contemporary patient cohort following correction of tetralogy of Fallot. Cardiol Young. 25(7):1268-75, 2015
Schelhorn J et al: Volumetric measurements in patients with corrected tetralogy of Fallot: comparison of short-axis versus axial cardiac MRI and echocardiography. Acta Radiol. 56(11):1315-22, 2015
Wald RM et al: Cardiac magnetic resonance markers of progressive RV dilation and dysfunction after tetralogy of Fallot repair. Heart. 101(21):1724-30, 2015
Lee C et al: Factors associated with right ventricular dilatation and dysfunction in patients with chronic pulmonary regurgitation after repair of tetralogy of Fallot: analysis of magnetic resonance imaging data from 218 patients. J Thorac Cardiovasc Surg. 148(6):2589-95, 2014
Lewis MJ et al: Usefulness of magnetic resonance imaging to guide referral for pulmonary valve replacement in repaired tetralogy of Fallot. Am J Cardiol. 114(9):1406-11, 2014
Sabate Rotes A et al: Long-term follow-up in repaired tetralogy of fallot: can deformation imaging help identify optimal timing of pulmonary valve replacement? J Am Soc Echocardiogr. 27(12):1305-10, 2014
Sun HY et al: Fetal MRI correlates with postnatal CT angiogram assessment of pulmonary anatomy in tetralogy of Fallot with absent pulmonary valve. Congenit Heart Dis. 9(4):E105-9, 2014
Chelliah A et al: Clinical utility of fetal magnetic resonance imaging in tetralogy of Fallot with absent pulmonary valve. Circulation. 127(6):757-9, 2013
Villafañe J et al: Hot topics in tetralogy of Fallot. J Am Coll Cardiol. 62(23):2155-66, 2013
Gartner RD et al: MRI and computed tomography of cardiac and pulmonary complications of tetralogy of fallot in adults. J Thorac Imaging. 25(2):183-90, 2010
Kilner PJ et al: Recommendations for cardiovascular magnetic resonance in adults with congenital heart disease from the respective working groups of the European Society of Cardiology. Eur Heart J. 31(7):794-805, 2010
McElhinney DB et al: Short- and medium-term outcomes after transcatheter pulmonary valve placement in the expanded multicenter US melody valve trial. Circulation. 122(5):507-16, 2010
Puranik R et al: Congenital heart disease and multi-modality imaging. Heart Lung Circ. 19(3):133-44, 2010
Wald RM et al: Effects of regional dysfunction and late gadolinium enhancement on global right ventricular function and exercise capacity in patients with repaired tetralogy of Fallot. Circulation. 119(10):1370-7, 2009
Chen SJ et al: Coronary artery anatomy in children with congenital heart disease by computed tomography. Int J Cardiol. 120(3):363-70, 2007
Raman SV et al: Usefulness of multidetector row computed tomography to quantify right ventricular size and function in adults with either tetralogy of Fallot or transposition of the great arteries. Am J Cardiol. 95(5):683-6, 2005
van Straten A et al: Right ventricular function late after total repair of tetralogy of Fallot. Eur Radiol. 15(4):702-7, 2005
Kang IS et al: Differential regurgitation in branch pulmonary arteries after repair of tetralogy of Fallot: a phase-contrast cine magnetic resonance study. Circulation. 107(23):2938-43, 2003
Nieman K et al: Coronary anomaly imaging by multislice computed tomography in corrected tetralogy of Fallot. Heart. 89(6):664, 2003
Uebing A et al: Influence of the pulmonary annulus diameter on pulmonary regurgitation and right ventricular pressure load after repair of tetralogy of Fallot. Heart. 88(5):510-4, 2002
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Clinical Issues
TERMINOLOGY
Definitions
Tetralogy of Fallot (TOF): 4 heart defects in combination
Obstruction to pulmonary outflow via infundibular right ventricular outflow tract (RVOT) narrowing or pulmonary valve stenosis
Secondary RV hypertrophy (RVH) from ↑ right ventricle (RV) pressures/fixed subpulmonary obstruction
Category: Cyanotic, normal heart size, ↓ pulmonary vascularity
Most common cyanotic congenital heart lesion
Hemodynamics: Obstruction to pulmonary blood flow via infundibular narrowing by anterior deviation of subpulmonary conal septum
Spectrum: Classic "blue tet," "pink tet," TOF with pulmonary atresia & major aortopulmonary collaterals (MAPCAs), TOF with absent pulmonary valve
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Echocardiographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Koppel CJ et al: Coronary anomalies in tetralogy of Fallot - a meta-analysis. Int J Cardiol. 306:78-85, 2020
Li VW et al: Ventricular myocardial deformation imaging of patients with repaired tetralogy of Fallot. J Am Soc Echocardiogr. 33(7):788-801, 2020
Mohamed I et al: Assessment of disease progression in patients with repaired tetralogy of Fallot using cardiac magnetic resonance imaging: a systematic review. Heart Lung Circ. 29(11):1613-20, 2020
Ojha V et al: Spectrum of changes on cardiac magnetic resonance in repaired tetralogy of Fallot: imaging according to surgical considerations. Clin Imaging. 69:102-14, 2020
Rizk J et al: Magnetic resonance imaging risk factors for ventricular arrhythmias in tetralogy of Fallot. Pediatr Cardiol. 41(5):862-8, 2020
Tous C et al: Ex vivo cardiovascular magnetic resonance diffusion weighted imaging in congenital heart disease, an insight into the microstructures of tetralogy of Fallot, biventricular and univentricular systemic right ventricle. J Cardiovasc Magn Reson. 22(1):69, 2020
Apostolopoulou SC et al: Cardiovascular imaging approach in pre and postoperative tetralogy of Fallot. BMC Cardiovasc Disord. 19(1):7, 2019
Egbe AC et al: Coronary artery disease in adults with tetralogy of Fallot. Congenit Heart Dis. 14(3):491-7, 2019
Leonardi B et al: The role of 3D imaging in the follow-up of patients with repaired tetralogy of Fallot. Eur Rev Med Pharmacol Sci. 23(4):1698-709, 2019
Larios G et al: Imaging in repaired tetralogy of Fallot with a focus on recent advances in echocardiography. Curr Opin Cardiol. 32(5):490-502, 2017
Lapierre C et al: Tetralogy of Fallot: preoperative assessment with MR and CT imaging. Diagn Interv Imaging. 97(5):531-41, 2016
Shin YR et al: Factors associated with progression of right ventricular enlargement and dysfunction after repair of tetralogy of Fallot based on serial cardiac magnetic resonance imaging. Eur J Cardiothorac Surg. 50(3):464-9, 2016
Vaujois L et al: Imaging of postoperative tetralogy of Fallot repair. Diagn Interv Imaging. 97(5):549-60, 2016
Wijesekera VA et al: Sequential right and left ventricular assessment in posttetralogy of Fallot patients with significant pulmonary regurgitation. Congenit Heart Dis. 11(6):606-14, 2016
Chan FP et al: Computed tomography and magnetic resonance imaging in neonates with congenital cardiovascular disease. Semin Ultrasound CT MR. 36(2):146-60, 2015
Preim U et al: Delayed enhancement imaging in a contemporary patient cohort following correction of tetralogy of Fallot. Cardiol Young. 25(7):1268-75, 2015
Schelhorn J et al: Volumetric measurements in patients with corrected tetralogy of Fallot: comparison of short-axis versus axial cardiac MRI and echocardiography. Acta Radiol. 56(11):1315-22, 2015
Wald RM et al: Cardiac magnetic resonance markers of progressive RV dilation and dysfunction after tetralogy of Fallot repair. Heart. 101(21):1724-30, 2015
Lee C et al: Factors associated with right ventricular dilatation and dysfunction in patients with chronic pulmonary regurgitation after repair of tetralogy of Fallot: analysis of magnetic resonance imaging data from 218 patients. J Thorac Cardiovasc Surg. 148(6):2589-95, 2014
Lewis MJ et al: Usefulness of magnetic resonance imaging to guide referral for pulmonary valve replacement in repaired tetralogy of Fallot. Am J Cardiol. 114(9):1406-11, 2014
Sabate Rotes A et al: Long-term follow-up in repaired tetralogy of fallot: can deformation imaging help identify optimal timing of pulmonary valve replacement? J Am Soc Echocardiogr. 27(12):1305-10, 2014
Sun HY et al: Fetal MRI correlates with postnatal CT angiogram assessment of pulmonary anatomy in tetralogy of Fallot with absent pulmonary valve. Congenit Heart Dis. 9(4):E105-9, 2014
Chelliah A et al: Clinical utility of fetal magnetic resonance imaging in tetralogy of Fallot with absent pulmonary valve. Circulation. 127(6):757-9, 2013
Villafañe J et al: Hot topics in tetralogy of Fallot. J Am Coll Cardiol. 62(23):2155-66, 2013
Gartner RD et al: MRI and computed tomography of cardiac and pulmonary complications of tetralogy of fallot in adults. J Thorac Imaging. 25(2):183-90, 2010
Kilner PJ et al: Recommendations for cardiovascular magnetic resonance in adults with congenital heart disease from the respective working groups of the European Society of Cardiology. Eur Heart J. 31(7):794-805, 2010
McElhinney DB et al: Short- and medium-term outcomes after transcatheter pulmonary valve placement in the expanded multicenter US melody valve trial. Circulation. 122(5):507-16, 2010
Puranik R et al: Congenital heart disease and multi-modality imaging. Heart Lung Circ. 19(3):133-44, 2010
Wald RM et al: Effects of regional dysfunction and late gadolinium enhancement on global right ventricular function and exercise capacity in patients with repaired tetralogy of Fallot. Circulation. 119(10):1370-7, 2009
Chen SJ et al: Coronary artery anatomy in children with congenital heart disease by computed tomography. Int J Cardiol. 120(3):363-70, 2007
Raman SV et al: Usefulness of multidetector row computed tomography to quantify right ventricular size and function in adults with either tetralogy of Fallot or transposition of the great arteries. Am J Cardiol. 95(5):683-6, 2005
van Straten A et al: Right ventricular function late after total repair of tetralogy of Fallot. Eur Radiol. 15(4):702-7, 2005
Kang IS et al: Differential regurgitation in branch pulmonary arteries after repair of tetralogy of Fallot: a phase-contrast cine magnetic resonance study. Circulation. 107(23):2938-43, 2003
Nieman K et al: Coronary anomaly imaging by multislice computed tomography in corrected tetralogy of Fallot. Heart. 89(6):664, 2003
Uebing A et al: Influence of the pulmonary annulus diameter on pulmonary regurgitation and right ventricular pressure load after repair of tetralogy of Fallot. Heart. 88(5):510-4, 2002
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