Related Experiment Videos
Changing trends of congenital heart disease in adults: a catheterization laboratory perspective
Insights
Adults with congenital heart disease (CHD) now present with more complex conditions and prior surgeries. Despite advances, ventricular dysfunction and dysrhythmias remain common challenges for adults with CHD requiring cardiac catheterization.
Area of Science:
- Cardiology
- Adult Congenital Heart Disease (ACHD)
Background:
- Advances in cardiac surgery have increased survival rates for children with congenital heart disease (CHD), allowing more to reach adulthood.
- The evolving profile of adult patients with CHD undergoing cardiac procedures has not been previously analyzed.
Purpose of the Study:
- To assess changes in the characteristics of adult patients with CHD undergoing cardiac catheterization (CC) over the past two decades.
- To identify trends in lesion complexity, prior surgical history, and residual cardiac issues in adults with CHD.
Main Methods:
- Retrospective analysis of 329 adult patients with CHD who underwent cardiac catheterization.
- Comparison of current patient data with historical data from approximately 20 years prior.
- Data collected from both adult and pediatric referral centers.
Main Results:
- Adults with CHD undergoing CC today are more likely to have complex cardiac disease compared to 20 years ago.
- A higher proportion of these adult patients have a history of prior cardiac surgery.
- Ventricular dysfunction and dysrhythmias are common residual issues in adults with CHD, even after aggressive surgical management.
- Premature coronary artery disease appears to be uncommon in this population.
Conclusions:
- The demographic and clinical profile of adults with CHD requiring cardiac catheterization has significantly changed.
- Increased complexity and prior surgical interventions characterize the current adult CHD population.
- Healthcare planning for adults with CHD must account for these evolving characteristics, including prevalent ventricular dysfunction and dysrhythmias.
Abstract:
Advances in cardiac surgery now enable many children with congenital heart disease (CHD) to survive to adulthood. The influence of such advances on the frequency of various lesions among adult patients undergoing cardiac catheterization (CC) has not previously been addressed. This retrospective analysis of 329 adults with CHD undergoing CC at an adult and at a pediatric referral center demonstrates that when compared to 20 years ago, adults with CHD who now undergo CC are more likely to have complex cardiac disease, and more have had prior surgery. In addition, despite more aggressive surgical management, ventricular dysfunction and dysrhythmias are now commonly encountered residua of CHD in adults who require diagnostic CC. Premature coronary artery disease appears uncommon. These changing characteristics of adults with CHD require consideration in the planning of future health care for these patients.