Congenital heart disease and right heart

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.