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Adult congenital heart disease: principles and management guidelines: Part II
1Cardiology Department, Green Lane Hospital, Auckland, New Zealand.
Insights
Many adults with congenital heart disease require lifelong care due to persistent issues. Specialized adult cardiology expertise is crucial for managing this growing patient population, especially after cardiac surgery.
Area of Science:
- Cardiology
- Adult Congenital Heart Disease (ACHD)
Background:
- Congenital heart disease (CHD) often results in lifelong medical needs, requiring palliative treatment.
- Persistent residuals and sequelae of CHD necessitate ongoing medical supervision into adulthood.
- Trivial lesions like patent ductus arteriosus (PDA) and secundum atrial septal defect (ASD) may be surgically curable but still require monitoring.
Purpose of the Study:
- To highlight the increasing prevalence of adult congenital heart disease (ACHD).
- To emphasize the need for specialized adult cardiology care for ACHD patients.
- To underscore the importance of developing expertise in ACHD for managing post-surgical patients.
Main Methods:
- Review of the current landscape of adult congenital heart disease management.
- Estimation of the prevalence of ACHD in the adult population.
- Assessment of the impact of cardiac surgery on ACHD patients.
Main Results:
- The prevalence of ACHD is rising, with an estimated over 2000 cases per million adults by 2000.
- A significant proportion (one-third) of ACHD patients have undergone cardiac surgery.
- Continued medical supervision by adult cardiologists is mandatory for most ACHD patients.
Conclusions:
- Adult congenital heart disease represents a growing patient population requiring specialized care.
- Expert medical assessment by adult cardiologists and other specialists is essential.
- Developing dedicated ACHD expertise in major centers is critical to meet the needs of this population.
Abstract:
The treatment of congenital heart disease may be palliative because many residua and sequelae persist into adulthood. Except for trivial lesions and anomalies such as PDA or secundum ASD where surgical cure is possible, continued supervision is mandatory. These patients deserve expert medical assessment from adult cardiologists and from other specialists when appropriate. The prevalence of postoperative adult congenital heart disease is increasing: by the year 2000 it is estimated that over 2000 in each million of the adult population will have congenital heart disease, one third of these having undergone cardiac surgery. It is important that some adult cardiologists in each major centre develop skills in adult congenital heart disease for this new patient population.