The Failing Right Ventricle in Adult Congenital Heart Disease

Given the reproducibility and success of congenital heart surgery in infancy, many patients now survive into adult life with late onset of right heart failure [1]. For these patients right ventricular function may determine symptomatic burden, quality of life and ultimate prognosis. Either naturally or following corrective surgery, the morphological right ventricle usually ejects blood into the pulmonary circulation. In the minority with transposition complexes, it may support the systemic circulation in which case the right ventricle determines longevity [2, 3]. As such this chamber can adapt and pump against systemic afterload for decades. Because of its importance in congenital heart disease, preservation of right ventricular function is increasingly in focus [4, 5].