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Congenital heart disease in adults: catheterization laboratory considerations
James M Fox1, Katherine D Bjornsen, Larry T Mahoney
1Department of Internal Medicine, The University of Iowa, Iowa City, Iowa, USA.
Insights
Congenital heart defects (CHDs) are common birth defects requiring lifelong cardiology care. Adult cardiologists must understand CHDs for accurate diagnosis and management, utilizing noninvasive assessments and cardiac catheterization for therapy.
Area of Science:
- Cardiology
- Pediatrics
- Adult Congenital Heart Disease
Background:
- Congenital heart defects (CHDs) are the most prevalent birth defects.
- An increasing number of CHD patients are now adults requiring specialized cardiologic care.
- Complex CHDs can be diagnosed for the first time in adolescence and adulthood.
Purpose of the Study:
- To highlight the growing need for adult cardiologists to be proficient in managing congenital heart defects.
- To outline the essential diagnostic and therapeutic approaches for patients with CHDs.
Main Methods:
- Comprehensive patient evaluation including detailed history and physical examination.
- Noninvasive diagnostic assessments.
- Cardiac catheterization for diagnosis and therapeutic interventions.
Main Results:
- Successful surgical interventions are common, but long-term follow-up is crucial.
- Cardiac catheterization remains vital for diagnosis and increasingly for therapy in CHD patients.
- Interventional procedures offer viable therapeutic options for pre- and postoperative patients.
Conclusions:
- Adult cardiologists require enhanced familiarity with congenital heart defects.
- A combination of clinical assessment, noninvasive methods, and cardiac catheterization is key for managing CHD patients.
- Interventional cardiology plays a significant role in the treatment of adult congenital heart disease.
Abstract:
Congenital heart defects are the most common birth defects and represent an increasing proportion of adolescent and adult patients followed by cardiologists. While many of these patients have undergone successful palliative or corrective surgery with excellent functional results, most of them still require careful follow-up. Further, even complex lesions may first be diagnosed in adolescence and adulthood. Therefore, cardiologists caring for adults need to become more familiar with these defects. Assessment of the patient with known or suspected congenital heart defects requires a careful history, physical examination, and noninvasive assessment. In addition, the catheterization laboratory remains a critical venue for diagnosis and, increasingly, therapy. Pressure measurements, oximetry, and angiography remain cornerstones of diagnosis in selected patients and a variety of interventional procedures have become viable therapeutic alternatives in both pre- and postoperative patients.