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Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Adults With Congenital Heart Disease—a New, Expanding Group of Patients
Brigitte Stiller1, Sebastian Grundmann, René Höhn
1Department of Congenital Heart Defects and Pediatric Cardiology, University Medical Center Freiburg, Faculty of Medicine, Albert-Ludwigs-Universität Freiburg, Germany; Department of Cardiology, University Medical Center Freiburg, Faculty of Medicine, Albert-Ludwigs-Universität Freiburg, Germany; Department of Cardiovascular Surgery, University Medical Center Freiburg, Faculty of Medicine, Albert-Ludwigs-Universität Freiburg, Germany; German Heart Center Berlin, Department of Congenital Heart Surgery - Pediatric Heart Surgery, Berlin; German Center for Cardiovascular Research, Partner Site Berlin, Germany; Department of Cardiology III: Adult Congenital and Valvular Heart Disease, University Hospital of Münster.
Insights
Adults with congenital heart disease (ACHD) require specialized lifelong care. Multidisciplinary management by primary care physicians and cardiologists is essential for optimal treatment of this growing patient population.
Area of Science:
- Cardiology
- Pediatrics
- Internal Medicine
Background:
- Congenital heart anomalies affect ~1% of newborns, with over 90% surviving to adulthood.
- This growing population necessitates specialized care beyond pediatric cardiology.
- Adults with congenital heart disease (ACHD) require lifelong management.
Conclusions:
- Care for ACHD is a multidisciplinary effort.
- Primary care physicians must provide basic care.
- Specialized cardiologists are essential for optimal, individualized treatment.
Background:
Congenital heart anomalies are the most common type of organ malformation, affecting approximately 1% of all newborn infants. More than 90% of these children now survive into adulthood. They need to be cared for by specialists for adults with congenital heart disease (ACHD), as well as by family physicians, internists, and cardiologists who are adequately versed in the basic management of persons with this lifelong condition.
Methods:
This review is based on pertinent publications retrieved by a selective literature search, including guidelines and consensus statements from Germany and abroad.
Results:
Cardiovascular malformations cover a very wide spectrum, and the evidence base for the treatment of older patients with these conditions is scant. Congestive heart failure, arrhythmias, and the sequelae of pulmonary arterial hypertension are the main contributors to cardiac morbidity and mortality. Preg - nancy counseling, endocarditis prophylaxis, vaccinations, and psychosocial aspects must be targeted to each individual patient. Neither the affected patients nor their family physicians are yet adequately acquainted with the recently created care structures for this patient group.
Conclusion:
The care of ACHD is a multidisciplinary task that requires basic care by primary care physicians as well as the involvement of specialized cardiologists in order to ensure optimal individualized treatment.
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