Congenital heart disease in the adult

2020 ◽  
pp. 3559-3595
Author(s):  
S.A. Thorne
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Specialist Care ◽  
Term Survival ◽  
The United Kingdom ◽  
Developing Heart ◽  
Growing Population

Adults with congenital heart disease are a growing population, and now outnumber children with congenital heart disease in the United Kingdom. Many patients with repaired hearts can now, with specialist care, expect to live a normal or near normal lifespan. Other survivors have complex, surgically altered hearts and circulations that reflect the surgical and interventional practices of the preceding two decades. Their long-term outlook is unknown and they remain at lifelong risk of complications that may require further intervention. The organization of services to provide specialist care is key to their long-term survival. As the population of adults with congenital heart disease ages, so the number developing heart failure increases. Services caring for patients need to develop a robust end-of-life pathway that focuses on symptoms and quality of life, and runs in parallel with other therapies.

Congenital heart disease in the adult

2010 ◽  
pp. 2842-2872
Author(s):  
S. A. Thorne
Keyword(s):  
Congenital Heart Disease ◽  
United Kingdom ◽  
Heart Disease ◽  
Congenital Heart ◽  
Specialist Care ◽  
Term Survival ◽  
Long Term Survival ◽  
The United Kingdom ◽  
Growing Population

Adults with congenital heart disease are a growing population, and now outnumber children with congenital heart disease in the United Kingdom. Many patients with repaired hearts can now, with specialist care, expect to live a normal or near normal lifespan. Other survivors have complex, surgically altered hearts and circulations that reflect the surgical and interventional practices of the preceding two decades. Their long-term outlook is unknown and they remain at lifelong risk of complications that may require further intervention. The organization of services to provide specialist care is key to their long-term survival....

Surgery for Congenital Heart Disease: Improvements in Outcomes

2018 ◽  
Vol 35 (06) ◽  
pp. 557-560 ◽  
Author(s):  
Richard Jonas ◽  
Gerard Martin
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Complex Congenital Heart Disease ◽  
Term Outcome ◽  
Term Survival ◽  
Younger Age ◽  
Care Outcomes ◽  
Moderate Complexity

AbstractCardiac surgery for congenital heart disease has changed dramatically since the first surgery in 1938. During the early era, children underwent surgery at older ages often with palliative procedures before their corrective operation. Not surprisingly, in the early era, there was considerably higher early and late mortality, including the additive risks of having more than one procedure and a long period of living with an unphysiological palliated circulation. Over time with advances in noninvasive diagnosis, surgical approach, cardiopulmonary bypass techniques, and team-based care, outcomes have improved. Children now undergo corrective surgery at a younger age and have fewer palliative procedures. Short-term outcome as measured by the commonly used metric “procedural early mortality” (i.e., death before hospital discharge or less than 30 days following a surgical procedure) is now as low as 1 or 2% for many low-to-moderate complexity procedures. Late outcomes have also improved with long-term survival of hospital survivors for simple lesions being close to population controls. Late outcomes for more complex defects still show diminishing survival relative to a control population. Examination of the causes of death provides insights into areas in which clinical improvements may further improve the outlook for children with complex congenital heart disease.

Abstract 2132: Late Functional Outcomes after Operation for Ebstein’s Anomaly

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Morgan Brown ◽  
Joseph A Dearani ◽  
Gordon K Danielson ◽  
Frank Cetta ◽  
Heidi M Connolly ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Functional Outcomes ◽  
Congenital Heart ◽  
Pulmonary Atresia ◽  
Complex Congenital Heart Disease ◽  
Ebstein Anomaly ◽  
Term Survival ◽  
Cardiac Medication

Objective To review the long-term functional outcomes of patients with Ebstein anomaly who had cardiac surgery at our institution. Methods From April 1, 1972 to January 1, 2006, 539 patients with Ebstein anomaly had 604 cardiac operations at Mayo Clinic Rochester. The 506 late survivors form the basis of this report. Patient records were reviewed and all patients were mailed a medical questionnaire or contacted by telephone. Patients who had associated complex congenital heart disease were excluded (pulmonary atresia, conotruncal abnormalities, and atrioventricular discordance and ventriculoarterial discordance). Results At the initial operation at our institution, the mean age was 24 years (range 8 days to 79 years) and 53% were female. Survival at 5, 10, 15, and 20 years was 94%, 90%, 86%, and 76%. Survival free of late reoperation was 86%, 74%, 62%, and 46% at 5, 10, 15, and 20 years respectively. Surveys were returned by 285 patients. Two hundred and thirty-seven (83%) of patients were in NYHA class I or II and 34% were taking no cardiac medication. Five patients (2%) reported having endocarditis, 1 patient (<1%) reported a stroke, and 103 patients (36%) had atrial fibrillation or flutter. There were a total of 202 pregnancies among 82 women. Recurrence of congenital heart disease was low. Only 9/232 (0.04%) of liveborn children had congenital heart disease. Conclusions Patients have good long term survival and functional outcomes, after operation for Ebstein anomaly. Atrial arrhythmias are relatively common both before and after operation. Pregnancy appears to be well tolerated with low recurrence risk of congenital heart disease.

scholarly journals Adult patients with congenital heart disease (GUCH): lights and shadows

2019 ◽  
Vol 13 (4) ◽  
pp. 189-199
Author(s):  
Luciano Daliento ◽  
Elettra Pomiato ◽  
Giovanni Vescovo ◽  
Massimo Padalino ◽  
Giovannella Russo
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Fetal Echocardiography ◽  
First Year ◽  
Term Survival ◽  
Surgery Outcome ◽  
The Sixties

More than 60 years have passed since Lillehei “The father of open surgery” started the era of correction of congenital heart diseases1. At the end of the sixties, only the minority of the patients with complex congenital heart diseases survived the first year after birth2; nowadays on the contrary, the grown-up congenital heart population exceeds the pediatric one3–5. The reasons of such a change are different: fetal echocardiography has made prenatal diagnosis of heart anomalies possible, thus causing the raise of interruptions of pregnancy. On the other hand, the high diagnostical accuracy and the brilliant surgery outcome along with an improved medical management allow higher survival rate6–8. Early during seventies Perloff foretold: “…it is a simple matter of time before a population of adult with congenital heart disease would emerge […]; we are obliged to look beyond the present and define our ultimate goal: the quality of life of long-term survival “9.

Disruptions in the development of feeding for infants with congenital heart disease

2020 ◽  
pp. 1-8
Author(s):  
Courtney E. Jones ◽  
Hema Desai ◽  
Jennifer L. Fogel ◽  
Karli A. Negrin ◽  
Andrea Torzone ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Oral Feeding ◽  
Feeding Difficulties ◽  
Sensory Regulation ◽  
Short And Long Term

Congenital heart disease (CHD) is the most common birth defect for infants born in the United States, with approximately 36,000 affected infants born annually. While mortality rates for children with CHD have significantly declined, there is a growing population of individuals with CHD living into adulthood prompting the need to optimise long-term development and quality of life. For infants with CHD, pre- and post-surgery, there is an increased risk of developmental challenges and feeding difficulties. Feeding challenges carry profound implications for the quality of life for individuals with CHD and their families as they impact short- and long-term neurodevelopment related to growth and nutrition, sensory regulation, and social-emotional bonding with parents and other caregivers. Oral feeding challenges in children with CHD are often the result of medical complications, delayed transition to oral feeding, reduced stamina, oral feeding refusal, developmental delay, and consequences of the overwhelming intensive care unit (ICU) environment. This article aims to characterise the disruptions in feeding development for infants with CHD and describe neurodevelopmental factors that may contribute to short- and long-term oral feeding difficulties.

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