Echocardiographic surveillance in children after tetralogy of Fallot repair: Adherence to guidelines?
BACKGROUND
Longitudinal clinical surveillance by transthoracic echocardiography (TTE) is an established practice in children with repaired tetralogy of Fallot (TOF). Non-Invasive Imaging Guidelines recommends a list of reporting elements that should be addressed during routine TTE in this population. In this study, we assessed the adherence to these recommendations.


METHODS
This was a multi-center (n = 8) retrospective review of TTE reports in children ≤11 years of age who have had complete TOF repair. We included 10 patients from each participating center (n = 80) and scored 2 outpatient follow-up TTE reports on each patient. The adherence rate was based on completeness of TTE reporting elements derived from the guidelines.


RESULTS
We reviewed 160 TTE reports on 80 patients. Median age was 4.4 months (IQR 1.5-6.6) and 3.6 years (IQR 1.3-6.4) at the time of complete surgical repair and first TTE report, respectively. The median adherence rate to recommended reporting elements was 61% (IQR 53-70). Of the 160 reports, 9 (7%) were ≥80% adherent and 40 (25%) were ≥70% adherent. Quantitative measurements of right ventricular outflow tract (RVOT), right ventricular (RV) size and function, and branch pulmonary arteries were least likely to be reported.


CONCLUSIONS
Overall adherence to the most recent published imaging guidelines for surveillance of children with repaired TOF patients was suboptimal, especially for reporting of RVOT, RV size and function, and branch pulmonary arteries. Further studies are needed to explore the barriers to adherence to guidelines and most importantly, whether adherence is associated with clinical outcomes.
['Annavajjhala|Vidhya|V|', 'Valente|Anne Marie|AM|', 'Lopez|Leo|L|', 'Sachdeva|Ritu|R|', 'Glickstein|Julie S|JS|', 'Natarajan|Shobha S|SS|', 'Buddhe|Sujatha|S|', 'Altmann|Karen|K|', 'Soriano|Brian D|BD|', 'Colquitt|John L|JL|', 'Altman|Carolyn A|CA|', 'Sasaki|Nao|N|', 'Sakarovitch|Charlotte|C|', 'Tacy|Theresa A|TA|', 'Geva|Tal|T|', 'Selamet Tierney|Elif Seda|ES|']
D002648:Child D004452:Echocardiography D006352:Heart Ventricles D006801:Humans D007223:Infant D011651:Pulmonary Artery D012189:Retrospective Studies D013771:Tetralogy of Fallot D016896:Treatment Outcome
Tetralogy of Fallot Adherence Guidelines Echocardiography