IMAGING ADULTS WITH CONGENITAL HEART DISEASE: Edited by Sherif NaguehImaging in repaired tetralogy of Fallot with a focus on recent advances in echocardiographyLarios, Guillermo; Friedberg, Mark K.Author Information Division of Cardiology, Department of Pediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Correspondence to Dr. Mark K. Friedberg, MD, Division of Cardiology, Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada. Tel: +1 416 813 7239; fax: +1 416 813-7547; e-mail: [email protected] Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.co-cardiology.com). Current Opinion in Cardiology: September 2017 - Volume 32 - Issue 5 - p 490-502 doi: 10.1097/HCO.0000000000000426 Buy SDC Metrics Abstract Purpose of review Imaging is essential for the management of adults with repaired tetralogy of Fallot (rToF). Echocardiography and cardiac magnetic resonance imaging are the central modalities to assess rToF. Here we review recent literature on imaging rToF, focusing on echocardiography and advances in assessment of cardiac mechanics. Recent findings Several two-dimensional, three-dimensional, and Doppler echo parameters have been proposed to assess pulmonary regurgitation, right ventricular volumes and ejection fraction, but most of them still have important limitations in their feasibility and reliability compared to cardiac magnetic resonance (CMR). Myocardial deformation imaging to study ventricular and atrial mechanics, regional function, ventricular–ventricular interactions, and electro-mechanical dyssynchrony has yielded insights into the pathophysiologic mechanisms of right ventricular and left ventricular dysfunction; thereby predicting clinical outcomes and exercise capacity, allowing among others, evaluation of the impact of pulmonary valve replacement (PVR). Emerging technologies are expected to further our understanding of the drivers of dysfunction and guide indications and timing of PVR. Summary Echocardiography and CMR have complementary and overlapping roles in rToF and contribute to our understanding of its pathophysiology and management. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.