We studied pre- and postoperative regional right and left ventricular wall motion and global ejection fraction in 18 patients with tetralogy of Fallot who had successful repair, and compared these values to those of patients with a history of Kawasaki disease as controls. Right ventricular ejection fraction was significantly lower in the preoperative group (52 +/- 4%) than that in the control group (57 +/- 4%), and that in the postoperative state (49 +/- 4%) was significantly lower than those in the control and preoperative groups. Left ventricular ejection fraction was significantly lower in the preoperative group (56 +/- 7%) than that in the control group (61 +/- 5%), while that in the postoperative state (64 +/- 6%) was significantly higher than those in the control and preoperative groups. Regional ventricular wall motion analysis revealed that shortening fractions in the tricuspid valve region were reduced in the preoperative patients and were persistent even after successful repair; those in the right ventricular outflow tract region were decreased after the correction. Regional left ventricular wall motion showed that shortening fractions in the anterolateral region were improved after the correction. We conclude that right ventricular dysfunction was present in the preoperative patients with tetralogy of Fallot and was persistent even after total correction.