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Pulmonary Regurgitation Post-TOF — RACP Paediatrics MCQ

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HardCardiologyPulmonary Regurgitation Post-TOFRACP Paediatrics

A 3-year-old with previously repaired tetralogy of Fallot develops progressive exercise intolerance and a wide-split S2 with a low-pitched diastolic murmur at the left sternal edge. What is the most likely complication?

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Correct answer: B — Pulmonary regurgitation leading to RV dilatation

Chronic pulmonary regurgitation is the most common long-term complication after TOF repair (transannular patch). It leads to progressive RV dilatation and dysfunction. Pulmonary valve replacement (surgical or transcatheter) is indicated when RV dilatation reaches threshold volumes on cardiac MRI.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Tetralogy of Fallot Follow-Up