Objectives: To determine the prevalence of aortic root dilation and aortic regurgitation (AR) after tetralogy of Fallot (TOF) repair, as well as associated risk factors.

Methods: Aortic dimensions, adjusted for body surface area and expressed as Z-scores, and AR were assessed by echocardiography in 24 patients at 7.4±7.5 years after repair of TOF.

Results: The Z-scores of the aortic dimensions at the levels of the annulus, sinus of Valsalva, sinotubular junction, and ascending aorta were 3.9±2.5, 4.1±1.5, 3.9±1.7, 4.1±2.1 respectively, all of which were significantly greater than the reference mean of Z=0±2 (p<0.001). The annulus, sinus of Valsalva, sinotubular junction, and ascending aorta were dilated in 91.6%, 91.6%, 91.6%, and 87.5% of patients respectively. However, there was no significant association between the enlarged aortic roots in the TOF patients to the age at surgical repair, age at follow-up, duration of follow-up after repair, body surface area, gender, or previous palliation. Five of the 24 patients (20%) had AR, which was trivial or mild in four, and moderate-to-severe in one. There were no statistically significant differences in the aortic Z-scores of patients with or without AR.

Conclusion: Although there is a significant prevalence of aortic root dilation following repair of TOF, the presence and progression of aortic root dilation was not associated with any of the hemodynamic or demographic variables measured here. Aortic root dilatation appearing after TOF repair may be solely due to individual histopathological changes and does not appear to be hemodynamically or surgically significant at 7.4±7.5 years follow-up.