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STATE-OF-THE-ART PAPER

Adult Congenital Heart Disease

Importance of the Right Ventricle

Divisions of Cardiovascular Diseases and Pediatric Cardiology and Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota

Manuscript received April 6, 2009; accepted June 3, 2009.

^_* Reprint requests and correspondence: Dr. Carole A. Warnes, Mayo Clinic, Gonda 5-368, 200 First Street SW, Rochester, Minnesota 55905 (Email: warnes.carole{at}mayo.edu).

The right ventricle (RV) is of lesser importance in acquired heart disease, but its role is of increasing importance in congenital heart disease. It may function as a subpulmonary ventricle or as a subaortic (systemic) ventricle in transposition complexes. The RV has a remarkable ability to adapt to pressure and volume load, but its size and function are often overlooked. Patients usually develop symptoms only after RV dysfunction has occurred, and in many diverse clinical scenarios, late referral is common. Advanced RV enlargement and dysfunction are responsible for not only impaired functional capacity but also lethal ventricular arrhythmias and sudden death. Appropriate imaging of the size and function of the RV are important because timely surgery on the pulmonary and tricuspid valves may preserve RV size and function. Adults with congenital heart disease should be followed at centers where there is an understanding of these problems so that valvular surgery can be considered when appropriate.

Key Words: adult congenital • pediatric • heart disease

Abbreviations and Acronyms   AV = atrioventricular   EF = ejection fraction   LV = left ventricle/ventricular   PS = pulmonary stenosis   PVR = pulmonary valve replacement   RV = right ventricle/ventricular   RVOT = right ventricular outflow tract   TR = tricuspid regurgitation   VSD = ventricular septal defect   VT = ventricular tachycardia

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J. Am. Coll. Cardiol. 2009 54: A32. [Full Text] [PDF]