Effects of Changes in Fluid Status on Right Ventricular Volumes and Function

Inclusion Criteria: 1. TOF patients who have had repair using a transannular patch. 2. Patients that present with free pulmonary insufficiency. 3. Are older than 18 years. Exclusion Criteria: 1. Patients who have lesions predisposing to chronic volume overload (i.e. patients with significant residual postoperative ventricular septal defects (VSD), or large aorto-pulmonary collaterals or more than moderate tricuspid insufficiency) since all these hemodynamic conditions can influence the late function of the right ventricle and potentially affect the response of the right side of the heart in changes in volume status 2. Patients who had a valve sparing TOF repair and have less than free pulmonary insufficiency. 3. Patients who have significant residual right-sided obstruction (i.e. patients who have residual RVOT obstruction or significant residual branch pulmonary artery stenosis), as it is shown that residual pulmonary stenosis may protect from RV dilation and from deterioration of the RV function. 4. Patients who cannot be reconstructed with a transannular patch and/or require a right ventricle to pulmonary artery homograft for reconstruction including: * pulmonary atresia and VSD * patients with anomalous coronary crossing the right ventricular outflow tract (RVOT) and * patients with TOF-absent pulmonary valve syndrome. 5. Patients with renal failure and renal insufficiency 6. Patients with uncompensated heart failure 7. Cancer patients 8. Latex allergic patients 9. Patients with diabetes 10. Pregnant females 11. Prisoners 12. Individuals who lack consent capacity