Right Ventricular Remodeling in Complex Congenital Heart Disease

Area of Science:

• Cardiology
• Pediatric Cardiology
• Cardiovascular Surgery

Background:

• Morphologic right ventricle (RV) in complex congenital heart diseases (CHDs) faces lifelong stressors.
• These stressors include pressure/volume overload, hypoxia, ischemia, and surgical stress, leading to RV remodeling, maladaptation, and dysfunction.

Purpose of the Study:

• To review macroscopic RV remodeling in various CHDs.
• To explore RV remodeling trajectories, surgical effects, and residual lesion repair.
• To discuss RV metabolism, genetics, imaging, and advanced management strategies.

Main Methods:

• Literature review of RV remodeling in CHDs.
• Analysis of specific CHD types: Tetralogy of Fallot, Ebstein anomaly, TGA, and Fontan palliation.
• Exploration of metabolic, genetic, and imaging criteria for RV remodeling.

Main Results:

• Detailed examination of RV remodeling patterns in diverse CHDs.
• Assessment of how surgical interventions and repairs influence RV remodeling.
• Identification of key factors affecting RV adaptation and dysfunction.

Conclusions:

• Understanding RV remodeling trajectories is crucial for managing CHDs.
• Timely intervention for residual lesions and advanced heart failure management can prevent RV deterioration.
• Targeting metabolism, genetics, and imaging may offer novel therapeutic approaches.