The role of the atria in congenital heart disease.

The atria play an important role in adult congenital heart disease. Atrial function is often altered due to longstanding pressure or volume overload. Cardiac surgery inflicts lasting damage to the atria, which leads to loss of atrial compliance. Both the history of atrial overload and the atrial scarring form substrates for atrial tachycardias. There has been a growing interest in the interatrial septum in the past few years. There is evidence for a role of the persisting foramen ovale and atrial septal aneurysm as a causative or permissive factor in cerebral stroke. Catheter closure of the PFO may be an attractive option, especially for younger patients.