aRL shunting after repair of TOF is associated with better RAEF and peak longitudinal strain, especially in the elective repair strategy. aRL shunting is a common finding after repair of TOF (C, color and spectral Doppler illustration of predominantly right-to-left atrial shunting) but is poorly understood. In this study, we aimed to investigate the associations of this finding to echocardiographic measures of diastolic function, such as RA peak longitudinal strain, a metric that is dramatically changed from pre- to postoperative (Postop.) states (D, RA ejection fraction and strain change from preoperative [top] and postoperative [bottom] states as assessed on STE). In our study, aRL shunting was associated with higher RAEF (A, global function) and peak longitudinal strain (B, conduit function), both in the overall cohort and in the elective repair group (B, mean differences [β] between aRL shunting group and reference group of all other shunting patterns, with 95% CIs and stratification by repair strategy). Periop., Perioperative.Download: Download high-res image (229KB)Download: Download full-size image

Central Illustration. aRL shunting after repair of TOF is associated with better RAEF and peak longitudinal strain, especially in the elective repair strategy. aRL shunting is a common finding after repair of TOF (C, color and spectral Doppler illustration of predominantly right-to-left atrial shunting) but is poorly understood. In this study, we aimed to investigate the associations of this finding to echocardiographic measures of diastolic function, such as RA peak longitudinal strain, a metric that is dramatically changed from pre- to postoperative (Postop.) states (D, RA ejection fraction and strain change from preoperative [top] and postoperative [bottom] states as assessed on STE). In our study, aRL shunting was associated with higher RAEF (A, global function) and peak longitudinal strain (B, conduit function), both in the overall cohort and in the elective repair group (B, mean differences [β] between aRL shunting group and reference group of all other shunting patterns, with 95% CIs and stratification by repair strategy). Periop., Perioperative.