February 2014

Advances in the diagnosis and management of congenital heart disease (CHD) have led to a marked improvement in the survival of patients with tetralogy of Fallot (TOF). However, residual anatomic and hemodynamic abnormalities are common. As with other types of congenital and acquired heart diseases, diagnostic information in patients with repaired TOF can be obtained using a variety of diagnostic tools. The choice of when to perform echocardiography, cardiovascular magnetic resonance (CMR) imaging, computed tomography (CT), nuclear scintigraphy, diagnostic catheterization, or a combination of these diagnostic procedures is dictated by the clinical question(s) asked and by a host of factors related to the patient, the modality, and the clinical circumstances. The aims of this document are to describe the role of each diagnostic modality in the care of patients with repaired TOF and to provide guidelines for a multimodality approach that takes into account patient-related and modality-related considerations.