Cardiac MRI in evaluation of post-operative congenital heart disease and complications

The aim of this work is to assess the uses of cardiac MR in evaluating post-operative congenital heart disease procedures and related complications. This is a retrospective study done in between December 2015 and October 2017, including 71 patients with age ranging from 6 months to 33 years (mean age 16.75). All of the patients were referred for post-operative evaluation after echocardiographic examination to exclude post-operative complications and to plan for re-intervention if needed. Forty-three percent of patients suffered from post-operative complications. The most common congenital heart disease coming for post-operative evaluation was tetralogy of Fallot (TOF) which represented 32% of the cases. The most common post-operative complication in all procedures was pulmonary branch stenosis (12.6%) followed by patch dilatation (9.8 %) and right ventricular failure (7%). In 7 patients following TOF repair, there was aneurysmal dilatation of the patch with significant pulmonary regurgitation. The regurgitation fraction was less than 40% in 3 of them, while the remaining 4 cases showed regurgitation fraction of more than 40%, an indication for re-intervention. MRI is an extremely useful imaging method for evaluation of normal and abnormal findings after surgical repair for congenital heart disease. It is effective in providing long-term surveillance and identifying post-procedural complications, which allowed us to further intervene on a timely manner when deemed necessary.