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CMR imaging in a 37 year-old patient with repaired TOF, severe pulmonary regurgitation, moderate tricuspid regurgitation (arrow), and severe right ventricular dilatation (end-diastolic volume index 386 ml/m2) and dysfunction (ejection fraction 15%). This patient who also exhibited severe heart failure symptoms had only modest decrease in RV size and no improvement in RV function after pulmonary valve replacement.
