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Heart Failure in Complex Congenital Heart Disease of the Adult

Anisa Chaudhry1, Julia Selwyn2, Elizabeth Adams1

  • 1Division of Cardiovascular Medicine, Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.

Current Cardiology Reports
|October 5, 2022
PubMed

Insights

Adult congenital heart disease (ACHD) patients with complex conditions are surviving longer. Advanced therapies, including new devices and heart transplantation, offer improved outcomes for heart failure in ACHD.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Heart Failure Management

Background:

  • Adult congenital heart disease (ACHD) survival rates have improved, particularly for complex cases like single-ventricle/Fontan physiology and systemic right ventricle.
  • Heart failure is an emerging concern in the growing ACHD population.

Purpose of the Study:

  • To describe heart failure phenotypes in complex ACHD.
  • To identify reversible causes of heart failure in ACHD.
  • To discuss considerations for advanced therapies in ACHD.

Main Methods:

  • Review of current literature on heart failure in ACHD.
  • Analysis of emerging device-based technologies for heart failure.
  • Evaluation of orthotopic heart transplant (OHT) in ACHD.

Main Results:

  • Newer heart failure devices and technologies are increasingly being applied to the ACHD population.
  • Addressing reversible causes of heart failure is a prerequisite for considering advanced therapies.
  • Advanced therapies like device implantation and OHT can improve morbidity and mortality in complex ACHD.

Conclusions:

  • Advanced therapies, including novel devices and OHT, should be carefully considered for end-stage heart failure in complex ACHD.
  • These interventions hold potential for significant improvements in survival and quality of life for ACHD patients.
  • A tailored approach is necessary for applying advanced therapies in the unique context of ACHD.
Abstract

Keywords:
Adult congenital heart diseaseHeart failureMechanical circulatory supportOrthotopic heart transplant

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