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Updated: Aug 26, 2026
Analysis of Congenital Heart Defects in Mouse Embryos Using Qualitative and Quantitative Histological Methods
Published on: March 10, 2020
Prevalence of congenital heart disease
Julien I E Hoffman1, Samuel Kaplan, Richard R Liberthson
1Department of Pediatrics, University of California, San Francisco, Calif 94143, USA. jhoffman@pedcard.ucsf.edu
Insights
Large numbers of adults with congenital heart disease are expected to survive, necessitating more adult cardiologists trained in managing complex heart conditions.
Area of Science:
- Cardiology
- Public Health
- Medical Statistics
Background:
- Most patients with congenital heart disease now survive childhood.
- The number of adult cardiologists needed for this growing population is unknown.
Purpose of the Study:
- Estimate the number of patients with congenital heart disease (CHD) born since 1940.
- Determine the number of survivors needing adult cardiology care.
- Categorize CHD by management complexity.
Main Methods:
- Estimated infant births with major CHD types using birth rates and incidence data.
- Calculated survival numbers based on natural history and treatment outcomes.
- Classified lesions as simple, moderate, or complex based on management expertise required.
Main Results:
- Approximately 1 million simple, 500,000 moderate, and 500,000 complex CHD cases born 1940-2002 in the US.
- Estimated 750,000 simple, 400,000 moderate, and 180,000 complex survivors with treatment.
- Over 3 million individuals with bicuspid aortic valves alive; survival estimates vary with and without treatment.
Conclusions:
- Significant numbers of adults with CHD will exist, whether treated or untreated.
- Increased training for adult cardiologists is likely required, especially for moderate and complex congenital heart lesions.
Background:
Today most patients with congenital heart disease survive childhood to be cared for by adult cardiologists. The number of physicians that should be trained to manage these lesions is unknown because we do not know the number of patients.
Methods:
To answer this question, the expected numbers of infants with each major type of congenital heart defect born in each 5-year period since 1940 were estimated from birth rates and incidence. The numbers expected to survive with or without treatment were estimated from data on natural history and the results of treatment. Finally, lesions were categorized as simple, moderate, or complex, based on the amount of expertise in management needed for optimal patient care.
Results:
From 1940 to 2002, about 1 million patients with simple lesions, and half that number each with moderate and complex lesions, were born in the United States. If all were treated, there would be 750,000 survivors with simple lesions, 400,000 with moderate lesions, and 180,000 with complex lesions; in addition, there would be 3,000,000 subjects alive with bicuspid aortic valves. Without treatment, the survival in each group would be 400,000, 220,000, and 30,000, respectively. The actual numbers surviving will be between these 2 sets of estimates.
Conclusions:
Survival of patients with congenital heart disease, treated or untreated, is expected to produce large numbers of adults with congenital disease, and it is likely that many more adult cardiologists will need to be trained to manage moderate and complex congenital lesions.
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