The right ventricle in congenital heart disease

P A Davlouros¹, K Niwa³, G Webb⁴, M A Gatzoulis¹

¹ Adult Congenital Heart Centre & Centre for Pulmonary Hypertension, Royal Brompton & Harefield NHS Trust, National Heart and Lung Institute, Imperial College, London, UK
² Congenital Heart Programme, Cardiology Division, Patras University Hospital, Rion, Patras, Greece
³ Adult Congenital Heart Disease Programme, Chiba Cardiovascular Center, Chiba, Japan
⁴ Philadelphia Adult Congenital Heart Center, University of Pennsylvania, Philadelphia, USA

Correspondence to:
Correspondence to:
Dr Periklis A Davlouros
Patras University Hospital, Rion, 26500, Patras, Greece; pdav{at}otenet.gr

In patients with congenital heart disease the right ventricle (RV) may support the pulmonary (subpulmonary RV) or the systemic circulation (systemic RV). During the last 50 years evidence is accumulating that RV dysfunction develops in many of these patients and leads to considerable morbidity and mortality. Therefore RV function in certain groups of congenital heart disease patients needs close surveillance and timely and appropriate intervention to optimise outcomes. Despite major progress being made, assessing the RV either in the subpulmonary or the systemic circulation remains challenging, often requiring a multi-imaging approach and expertise (echocardiography, magnetic resonance imaging, nuclear and occasionally invasive assessment with angiography). This review discusses the implications of volume and pressure loading of the RV in the context of congenital heart disease and describes the most relevant imaging modalities for monitoring RV function.

Abbreviations: ASD, atrial septal defect; ccTGA, congenitally corrected transposition of the great arteries; CHD, congenital heart disease; CMR, cardiac magnetic resonance; CT, computed tomography; MRI, magnetic resonance imaging; MSCT, multislice computed tomography; PR, pulmonary valve regurgitation; RNA, radionuclide angiography; RV, right ventricle; TOE, transoesophageal echocardiography; TR, tricuspid regurgitation

Keywords: congenital heart disease; right ventricle; imaging; transoesophageal echocardiography

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