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Durable Mechanical Circulatory Support in Adult Congenital Heart Disease: Reviewing Clinical Considerations and

Joshua Saef1,2, Robert Montgomery3, Ari Cedars4

  • 1Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.

Journal of Clinical Medicine
|June 10, 2022
PubMed

Insights

Adult congenital heart disease (ACHD) patients increasingly face heart failure (HF). Advanced therapies like mechanical circulatory support (MCS) are vital, and specialized approaches enable safe implantation with favorable outcomes in this growing population.

Area of Science:

  • Cardiology
  • Adult Congenital Heart Disease
  • Heart Failure Management

Background:

  • Adults with congenital heart disease (ACHD) represent a rapidly expanding group within cardiology.
  • Heart failure (HF) is the primary driver of morbidity and mortality in the ACHD population.
  • The demand for advanced HF therapies in ACHD patients is projected to increase significantly.

Purpose of the Study:

  • To highlight the growing need for advanced heart failure therapies in adults with congenital heart disease.
  • To emphasize the importance of specialized approaches for mechanical circulatory support (MCS) device implantation in ACHD patients.
  • To underscore the necessity of understanding ACHD-specific considerations for successful HF program outcomes.

Main Methods:

  • Review of current evidence regarding mechanical circulatory support (MCS) device implantation in ACHD patients.
  • Analysis of anatomic and physiologic challenges unique to ACHD patients requiring advanced HF therapies.
  • Assessment of the safety and outcomes associated with durable MCS in the ACHD population.

Main Results:

  • Durable mechanical circulatory support (MCS) devices can be implanted safely in ACHD patients.
  • Favorable outcomes are increasingly reported with MCS use in this population.
  • Specialized approaches are often required due to unique anatomic considerations in ACHD.

Conclusions:

  • Expansion of MCS utilization is crucial for improving clinical outcomes in ACHD patients with heart failure.
  • Successful implementation of advanced HF therapies in ACHD necessitates a deep understanding of their specific anatomic and physiologic profiles.
  • HF programs must adapt to provide effective care for the growing ACHD population requiring advanced support.

Keywords:
congenital heart diseasemechanical circulatory support

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