The right ventricle in tetralogy of Fallot

Surgical repair of tetralogy of Fallot (TOF) may be followed by various conditions and residual findings, early postoperatively or late during follow-up. Most of these conditions affect the right ventricular outflow tract and the pulmonary arteries and thus, indirectly, the right ventricle. This paper discusses the role of the right ventricle during the natural history of repaired TOF. The different imaging methods used to assess the function of the right ventricle in relation to this congenital heart disease are highlighted. Particular attention is focused on the volume overloaded right ventricle, as this condition is nowadays a subject of intense discussion, particularly regarding the appropriate timing for pulmonary valve replacement. The most recent literature on this topic is briefly reviewed. In summary, preservation of right ventricular function and prevention of right ventricular arrhythmias are crucial for these patients’ survival and outcome.