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Palliated congenital heart disease
1Section of Pediatric Cardiology, Mayo Clinic and Foundation, 200 First Avenue SW, Rochester, Minnesota 55905, USA.
Adolescent Medicine (Philadelphia, Pa.)
|February 27, 2001
Summary
Managing complex congenital heart disease in adolescents is challenging. Palliative shunts offer long-term palliation, but some patients may need advanced interventions like cardiac transplantation.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease Management
Background:
- Adolescent management of palliated complex congenital heart disease (CHD) poses significant challenges.
- Patients not candidates for complete circulatory separation may receive bidirectional cavopulmonary shunts (BCPS) with systemic-to-pulmonary shunts for palliation.
Purpose of the Study:
- To review the long-term management strategies for adolescents with complex congenital heart disease.
- To highlight the evolving treatment options including interventional catheterization, surgical techniques, and cardiac transplantation.
Main Methods:
- Review of clinical management strategies for adolescents with palliated complex CHD.
- Discussion of outcomes associated with palliative shunts and subsequent interventions.
Main Results:
- Bidirectional cavopulmonary shunts can provide decades of palliation for selected complex CHD patients.
- A subset of patients develop myocardial failure and atrial arrhythmias despite initial palliation.
- Interventional cardiac catheterization and novel surgical techniques can improve hemodynamic status in some patients.
Conclusions:
- Long-term management of complex congenital heart disease in adolescents requires a multidisciplinary approach.
- While palliative shunts and interventions offer benefits, cardiac transplantation remains a crucial option for end-stage disease in this population.