Abstract
In the field of congenital heart disease (CHD) the right heart is frequently affected, therefore understanding its dysfunction and discovering new modalities of evaluation may have clinical implications. In patients with CHD, the right ventricle (RV) is either considered the subpulmonary ventricle as is the case in atrial septal defects, pulmonary stenosis, and Tetralogy of Fallot, either the systemic ventricle, e.g. in transposition of the great arteries (TGA). Without corrective surgery for these lesions, right-sided heart failure may develop and severely complicate the evolution of these patients. Consequently, finding new means to evaluate the right ventricle is highly important and has prognostic relevance. The anatomy and shape of the right ventricle (RV) are complex, making its assessment more difficult. Generally, several imaging modalities can be utilized, mainly echocardiography, but also radionuclide imaging and, more recently, computed tomography (CT) and cardiac magnetic resonance (CMR). As mentioned before, in CHD the RV can functionally serve as the sub-pulmonary ventricle, however, it can also function as the systemic ventricle, in order to support pressure or volume overload or both.
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References
Davlouros PA, Niwa K, Webb G, Gatzoulis MA. The right ventricle in congenital heart disease. Heart. 2006;92(Suppl 1):i27–38. https://doi.org/10.1136/hrt.2005.077438.
Guihaire J, Haddad F, Mercier O, Murphy DJ, Wu JC, Fadel E. The right heart in congenital heart disease, mechanisms and recent advances. J Clin Exp Cardiolog. 2012;8(10):1–11. https://doi.org/10.4172/2155-9880.S8-010.
Pascotto M, Caso P, Santoro G, et al. Analysis of right ventricular Doppler tissue imaging and load dependence in patients undergoing percutaneous closure of atrial septal defect. Am J Cardiol. 2004;94(9):1202–5. https://doi.org/10.1016/j.amjcard.2004.07.098.
Vasquez AF, Lasala JM. Atrial septal defect closure. Cardiol Clin. 2013;31(3):385–400. https://doi.org/10.1016/j.ccl.2013.05.003.
Kort HW, Balzer DT, Johnson MC. Resolution of right heart enlargement after closure of secundum atrial septal defect with transcatheter technique. J Am Coll Cardiol. 2001;38(5):1528–32. https://doi.org/10.1016/S0735-1097(01)01547-9.
Schussler JM, Anwar A, Phillips SD, Roberts BJ, Vallabhan RC, Grayburn PA. Effect on right ventricular volume of percutaneous Amplatzer closure of atrial septal defect in adults. Am J Cardiol. 2005;95(8):993–5. https://doi.org/10.1016/j.amjcard.2004.12.046.
Baumgartner H, Task Force on the Management of Grown-up Congenital Heart Disease of the European Society of Cardiology (ESC), et al. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J. 2010;31:2915–57. https://doi.org/10.1093/eurheartj/ehq249.
Du ZD, Hijazi ZM, Kleinman CS, Silverman NH, Larntz K. Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: results of a multicenter nonrandomized trial. J Am Coll Cardiol. 2002;39(11):1836–44. https://doi.org/10.1016/S0735-1097(02)01862-4.
Alonso-González R, Dimopoulos K, Ho S, Oliver JM, Gatzoulis MA. The right heart in adults with congenital heart disease. Rev Esp Cardiol. 2010;63(9):1070–86. https://doi.org/10.1016/S1885-5857(10)70211-5.
Li W, Davlouros PA, Kilner PJ, et al. Doppler-echocardiographic assessment of pulmonary regurgitation in adults with repaired tetralogy of Fallot: comparison with cardiovascular magnetic resonance imaging. Am Heart J. 2004;147(1):165–72. https://doi.org/10.1016/s0002-8703(03)00527-1.
Silversides CK, Veldtman GR, Crossin J, et al. Pressure half-time predicts hemodynamically significant pulmonary regurgitation in adult patients with repaired tetralogy of Fallot. J Am Soc Echocardiogr. 2003;16(10):1057–62. https://doi.org/10.1016/S0894-7317(03)00553-4.
Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease). Circulation. 2008;118(23):2395–451. https://doi.org/10.1161/CIRCULATIONAHA.108.190811.
Discigil B, Dearani JA, Puga FJ, et al. Late pulmonary valve replacement after repair of tetralogy of Fallot. J Thorac Cardiovasc Surg. 2001;121(2):344–51. https://doi.org/10.1067/mtc.2001.111209.
d’Udekem Y, Rubay J, Shango-Lody P, et al. Late homograft valve insertion after transannular patch repair of tetralogy of Fallot. J Heart Valve Dis. 1998;7(4):450–4.
Vliegen HW, Van Straten A, De Roos A, et al. Magnetic resonance imaging to assess the hemodynamic effects of pulmonary valve replacement in adults late after repair of tetralogy of Fallot. Circulation. 2002;106(13):1703–7. https://doi.org/10.1161/01.CIR.0000030995.59403.F8.
Gatzoulis MA, Balaji S, Webber SA, et al. Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot: a multicentre study. Lancet. 2000;356(9234):975–81. https://doi.org/10.1016/S0140-6736(00)02714-8.
Nollert GDA, Däbritz SH, Schmoeckel M, Vicol C, Reichart B. Risk factors for sudden death after repair of tetralogy of Fallot. Ann Thorac Surg. 2003;76(6):1901–5. https://doi.org/10.1016/S0003-4975(03)01065-8.
Gatzoulis MA, Till JA, Somerville J, Redington AN. Mechanoelectrical interaction in tetralogy of Fallot: QRS prolongation relates to right ventricular size and predicts malignant ventricular arrhythmias and sudden death. Circulation. 1995;92(2):231–7. https://doi.org/10.1161/01.CIR.92.2.231.
Khairy P, Landzberg MJ, Gatzoulis MA, et al. Value of programmed ventricular stimulation after tetralogy of Fallot repair: a multicenter study. Circulation. 2004;109(16):1994–2000. https://doi.org/10.1161/01.CIR.0000126495.11040.BD.
Babu-Narayan SV, Kilner PJ, Li W, et al. Ventricular fibrosis suggested by cardiovascular magnetic resonance in adults with repaired tetralogy of Fallot and its relationship to adverse markers of clinical outcome. Circulation. 2015;113(3):405–14. https://doi.org/10.1161/CIRCULATIONAHA.105.548727.
Ghai A, Silversides C, Harris L, Webb GD, Siu SC, Therrien J. Left ventricular dysfunction is a risk factor for sudden cardiac death in adults late after repair of tetralogy of Fallot. J Am Coll Cardiol. 2002;40(9):1675–80. https://doi.org/10.1016/S0735-1097(02)02344-6.
Oechslin E, Buchholz S, Jenni R. Ebstein’s anomaly in adults: Doppler-echocardiographic evaluation. Thorac Cardiovasc Surg. 2000;48(4):209–13. https://doi.org/10.1055/s-2000-6900.
Nihoyannopoulos P, McKenna WJ, Smith G, Foale R. Echocardiographic assessment of the right ventricle in Ebstein’s anomaly: relation to clinical outcome. J Am Coll Cardiol. 1986;8(3):627–35. https://doi.org/10.1016/S0735-1097(86)80193-0.
Chauvaud S, Berrebi A, D’Attellis N, Mousseaux E, Hernigou A, Carpentier A. Ebstein’s anomaly: repair based on functional analysis. Eur J Cardiothorac Surg. 2003;23:525–31. https://doi.org/10.1016/S1010-7940(02)00836-9.
Mahle WT, Parks WJ, Fyfe DA, Sallee D. Tricuspid regurgitation in patients with repaired tetralogy of Fallot and its relation to right ventricular dilatation. Am J Cardiol. 2003;92(5):643–5. https://doi.org/10.1016/S0002-9149(03)00746-X.
Conte S, Jashari R, Eyskens B, Gewillig M, Dumoulin M, Daenen W. Homograft valve insertion for pulmonary regurgitation late after valveless repair of right ventricular outflow tract obstruction. Eur J Cardiothorac Surg. 1999;15(2):143–9. https://doi.org/10.1016/S1010-7940(98)00306-6.
Warnes CA. Adult congenital heart disease importance of the right ventricle. J Am Coll Cardiol. 2009;54(21):1903–10. https://doi.org/10.1016/j.jacc.2009.06.048.
Jarrar M, Betbout F, Farhat MB, et al. Long-term invasive and noninvasive results of percutaneous balloon pulmonary valvuloplasty in children, adolescents, and adults. Am Heart J. 1999;138(5):950–4. https://doi.org/10.1016/S0002-8703(99)70022-0.
Sadr-Ameli MA, Sheikholeslami F, Firoozi I, Azarnik H. Late results of balloon pulmonary valvuloplasty in adults. Am J Cardiol. 1998;82(3):398–400. https://doi.org/10.1016/S0002-9149(98)00302-6.
Lundstrom U, Bull C, Wyse RK, Somerville J. The natural and “unnatural” history of congenitally corrected transposition. Am J Cardiol. 1990;65(18):1222–9. https://doi.org/10.1016/0002-9149(90)90978-a.
Graham TP, Bernard YD, Mellen BG, et al. Long-term outcome in congenitally corrected transposition of the great arteries: a multi-institutional study. J Am Coll Cardiol. 2000;36(1):255–61. https://doi.org/10.1016/S0735-1097(00)00682-3.
Daliento L, Corrado D, Buja G, John N, Nava A, Thiene G. Rhythm and conduction disturbances in isolated, congenitally corrected transposition of the great arteries. Am J Cardiol. 1986;58(3):314–8.
Prieto LR, Hordof AJ, Secic M, Rosenbaum MS, Gersony WM. Progressive tricuspid valve disease in patients with congenitally corrected transposition of the great arteries. Circulation. 1998;98(10):997–1005. https://doi.org/10.1161/01.CIR.98.10.997.
Roos-Hesselink JW, Meijboom FJ, Spitaels SEC, et al. Excellent survival and low incidence of arrhythmias, stroke and heart failure long-term after surgical ASD closure at young age: a prospective follow-up study of 21-33 years. Eur Heart J. 2003;24(2):190–7. https://doi.org/10.1016/S0195-668X(02)00383-4.
Lissin LW, Li W, Murphy DJ, et al. Comparison of transthoracic echocardiography versus cardiovascular magnetic resonance imaging for the assessment of ventricular function in adults after atrial switch procedures for complete transposition of the great arteries. Am J Cardiol. 2004;93(5):654–7. https://doi.org/10.1016/j.amjcard.2003.11.044.
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Iancovici, S., Dorobanţu, M. (2018). Congenital Heart Disease and Right Heart. In: Dumitrescu, S., Ţintoiu, I., Underwood, M. (eds) Right Heart Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-73764-5_14
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