Early Versus Later Re-valving in Tetralogy of Fallot With Free Pulmonary Regurgitation

Exclusion Criteria

• •1. ToF with pulmonary atresia, ToF with common atrioventricular canal, ToF with absent pulmonary valve syndrome, major aortopulmonary collateral arteries and other significant associated anomalies.
• •2. Palliation with a shunt (Blalock-Taussig or central) at any time.
• •3. The patient is symptomatic.
• •4. Sustained supraventricular or ventricular arrhythmia.
• •5. RVEDVi \> 140 mL/m2 as assessed by MRI (appendix 1).
• •6. RVESVi \> 60 mL/m2 as assessed by MRI.
• •7. RVEF \< 50 % as assessed by MRI.
• •8. Moderate or severe tricuspid regurgitation as assessed by echocardiography or MRI.
• •9. Significant residual lesions requiring intervention (e.g. ventricular septal defect, aortic regurgitation, branch pulmonary artery stenosis).
• •10. Co-morbidity preventing exercise testing (e.g. genetics, neuro-cognitive dysfunction, physical disability).
• •11. Contraindication for MRI (e.g. permanent pacemaker, intra-cardiac defibrillator, intracranial ferro-magnetic device).
• •12. Pregnancy at time of inclusion.
• •13. Age \< 12 or unable to comply with instructions given during MRI or exercise testing.