Early Right Heart Chambers Reverse Remodeling in Patients Operated in Adulthood for Congenital Lesions Associated with Right Heart Chambers Enlargement

Background: Progressive right heart chambers dilatation is frequent in the adult congenital heart disease (ACHD) population. We evaluated the immediate and mid-term response of right heart chambers to surgery performed in adulthood for lesions associated with right heart chambers enlargement. Methods: Thirty-six adult patients with lesions associated with right heart chambers enlargement submitted to surgery were studied. We collected echocardiographic data of right ventricle (RV) mid-diameter, right atrial volume indexed, RV systolic pressure, and tricuspid annular plane systolic excursion (TAPSE) prior to surgery (T0), at 2 to 5 days (T1), and 3 to 6 months (T2) after surgery. Results: At T1, we observed a significant decrease of RV mid-diameter (47.2 +/- 8.4 vs. 39.6 +/- 7.4 mm, P<.001), right atrial volume indexed (45.6 +/- 26.6 vs. 27.2 +/- 11 ml/m2, P<.001), and RV systolic pressure (39 +/- 14.8 vs. 32.8 +/- 11.3 mm Hg, P=.03). At T2, a further significant deviation in the rate of RV diameter (39.6 +/- 7.4 vs. 34.5 +/- 5.1 mm, P<.001), in RV systolic pressure (32.8 +/- 11.3 vs. 25.3 +/- 5 mm Hg, P=.03) and TAPSE (13.9 +/- 3.2 vs. 15.8 +/- 2.6 mm, P<.001) was observed. Conclusions: Positive right heart chambers remodeling occurs as early as in the immediate post-operative period in most ACHD patients operated for lesions associated with right heart chambers enlargement.