Abstract 14411: Cardiac Magnetic Resonance Predictors of Adverse Outcomes in Tetralogy of Fallot: Lessons From the Single Center Outcomes Study in Tetralogy of Fallot (SCOUT-TOF)

Introduction:Survivors of tetralogy of Fallot repair (TOF) can be left residua which may subject them to adverse outcomes. A large single center cohort with uniform surgery and imaging using cardiac magnetic resonance (CMR) measures may be able to predict these complications.Methods:Retrospective, single center study of all TOF survivors who underwent CMR from 2005-November 2017. CMR variables were extracted from reports or images analyzed. Medical and surgical history were obtained. Associations were tested using logistic or linear regression.Results:A total 667 TOF survivors underwent CMR (median 14.5 yo); 56% were male, 68% had routine TOF, 21% had TOF with pulmonary atresia, and 5% had TOF with absent pulmonary valve. Most (70%) had a transannular patch. With a mean followup of 4.8 +3.9 years, numerous CMR measures predicted adverse outcomes (Table). As in a previous multicenter trial, higher RV mass/volume was a significant risk factor for death, however, we also found that lower RV ejection fraction (EF) and left pulmonary artery (LPA) flow, were also significantly associated with death. Not surprisingly, higher RV volumes (in absolute terms and relative to the left ventricle (LV)) were associated with pulmonary valve replacement (PVR), however, lower RV EF was also associated with PVR. LV EF was associated with ventricular tachycardia (VT). For exercise, higher RV mass/volume predicted lower anaerobic threshold (? -140, P=.04) and higher LV volumes (? 1.1, P<.02) and cardiac index (CI) (? 14.2, P=.05) predicted greater maximum work. No risk factors were identified for hospitalization or pacemaker placement.Conclusions:In a large single center study, multiple CMR measures were associated with adverse outcomes in TOF survivors. RV mass/volume, EF and LPA flow were associated with greater odds of death; RV mass/volume also predicted lower anaerobic threshold. LV EF was associated with greater odds of VT. LV volumes and CI predicted greater maximum work.