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The role of the atria in congenital heart disease

Folkert Meijboom1, Jolien Roos-Hesselink, Horst Sievert

  • 1Department of Cardiology, Thoraxcentre, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. Meijboom@alkg.azr.nl

Cardiology Clinics
|October 10, 2002
PubMed

Insights

The atria are crucial in adult congenital heart disease, with altered function often leading to atrial tachycardias. Interatrial septum abnormalities, like PFO, are increasingly linked to stroke, with catheter closure a potential treatment.

Area of Science:

  • Cardiology
  • Adult Congenital Heart Disease
  • Electrophysiology

Background:

  • Atrial function is significantly impacted in adult congenital heart disease due to chronic pressure or volume overload.
  • Cardiac surgery can cause atrial damage, reducing compliance and creating substrates for atrial tachycardias.
  • The interatrial septum is gaining attention for its role in cardiovascular conditions.

Purpose of the Study:

  • To explore the role of atrial alterations in adult congenital heart disease.
  • To investigate the association between interatrial septum abnormalities and cerebral stroke.
  • To evaluate the potential of catheter-based interventions for specific atrial conditions.

Main Methods:

  • Review of existing literature on atrial function in ACHD.
  • Analysis of evidence linking PFO and atrial septal aneurysm to stroke.
  • Discussion of catheter closure techniques for PFO.

Main Results:

  • Longstanding atrial overload and surgical scarring predispose to atrial tachycardias.
  • The persisting foramen ovale (PFO) and atrial septal aneurysm are implicated in cerebral stroke.
  • Catheter closure of PFO presents a viable therapeutic option, particularly for younger patients.

Conclusions:

  • Atrial remodeling and scarring are key factors in the pathophysiology of arrhythmias in ACHD.
  • Interatrial septum abnormalities warrant consideration in the workup of cryptogenic stroke.
  • Percutaneous closure of PFO offers a minimally invasive treatment for stroke prevention in select populations.

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