Application of Classic Heart Failure Definitions of Asymptomatic and Symptomatic Ventricular Dysfunction and Heart Failure Symptoms With Preserved Ejection Fraction to Patients With Systemic Right Ventricles

Monitoring the Patient with Transposition of the Great Arteries: Arterial Switch Versus Atrial Switch

“…Given this, quantitative measurements are best made serially for comparison over time, so that each patient acts as his/her own control. Methods used to assess ventricular performance in this group of patients have included myocardial performance index, fractional area change, and tricuspid annular plane systolic excursion (TAPSE) [70][71][72]. Given its ease of measurement [73] and prognostic importance in heart failure [73][74][75], of these methods, some prefer TAPSE.…”

Right Ventricle: Wrong Targets?

“…9 The incidence of systemic RV dysfunction is similar for patients who have undergone atrial redirection procedures for TGA. 10 However, in this cohort, clinical heart failure is somewhat less common and RV dysfunction predicts the risk of sudden cardiac death, which is the primary driver of mortality. 8,11,12 Although the full arsenal of conventional heart failure therapy (lifestyle modification, medication, electric therapies, transplant, and ventricular assist device) can and have been used in patients with systemic RV dysfunction, a lack of data specific to this population makes it difficult to know which strategy to adopt and who to target.…”

Atrial-Level Switch Operation

“…This analysis by Vejlstrup and colleagues shows us that our efforts should be targeted at preserving systemic ventricular function. 4,5 We can continue to learn from this population, particularly the relationship between systemic right ventricular function and the development of tricuspid regurgitation, as well as the trajectory of right ventricular failure compared with left ventricular failure.…”