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Clinical Profiles and Outcomes of Adult Congenital Heart Disease Patients in the Cardiac Intensive Care Unit

Luke J Burchill1, Viral K Desai1, Maan Jokhadar1

  • 1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.

JACC. Advances
|May 1, 2025
PubMed

Insights

Critically ill adult congenital heart disease (ACHD) patients admitted to cardiac intensive care units (CICU) face high mortality and readmission rates. Specialized care strategies are essential to improve outcomes for this vulnerable population.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Adult Congenital Heart Disease

Background:

  • Limited evidence exists to guide the care of critically ill adult congenital heart disease (ACHD) patients.
  • Improving outcomes for ACHD patients in intensive care settings is a significant clinical challenge.

Purpose of the Study:

  • To investigate the clinical characteristics and outcomes of ACHD patients admitted to an academic cardiac intensive care unit (CICU).
  • To identify factors associated with mortality and readmission in critically ill ACHD patients.

Main Methods:

  • A retrospective cohort study analyzed 12,428 CICU admissions from 2007-2018.
  • Included patients evaluated in an ACHD clinic; examined critical care diagnoses and therapies.
  • Logistic and Cox regression models assessed in-hospital and 1-year mortality.

Main Results:

  • 253 (2.0%) ACHD patients were identified, with 40.9% classified as severe.
  • ACHD patients experienced higher rates of heart failure and arrhythmias compared to non-ACHD patients.
  • In-hospital mortality was 8.7%, and 1-year survival was significantly lower for ACHD patients, especially those with critical care diagnoses or therapies. Readmission within 1 year affected 43.9% of survivors.

Conclusions:

  • Critically ill ACHD patients in the CICU have elevated mortality and high readmission rates.
  • Current treatment strategies may be insufficient, highlighting the need for tailored approaches.
  • Developing specialized care protocols is crucial for improving outcomes in this patient group.
Abstract

Keywords:
adult congenital heart disease (ACHD)atrial arrhythmiascardiac intensive care unit (CICU)critical care outcomesin-hospital mortalitypost-ICU readmission

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