Adult congenital heart disease
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Adult Congenital Heart Disease: An Overview
Prevalence and Survival Rates
Congenital heart disease (CHD) is the most common congenital anomaly, affecting approximately 0.8% to 1% of live births globally . Advances in medical, interventional, and surgical techniques over the past few decades have significantly improved survival rates, with more than 85% of children with CHD now surviving into adulthood . This has led to a growing population of adults living with congenital heart disease, shifting the focus of CHD care from pediatric to adult cardiology .
Lifelong Management and Follow-Up
Adults with congenital heart disease often require lifelong specialized care due to residual structural defects, valve lesions, or ventricular dysfunction that persist even after initial surgical or catheter-based interventions . Regular follow-up is crucial to monitor and manage these residual issues, with the frequency of follow-up determined by the clinical status and severity of any residual problems . Cardiac MRI (CMR) and echocardiography are standard techniques used for routine assessment and follow-up.
Complications and Comorbidities
Despite the advancements in treatment, adults with CHD face a range of long-term complications, including arrhythmias, heart failure, pulmonary hypertension, endocarditis, and the need for reoperations . These complications necessitate integrated care involving multidisciplinary teams to address not only cardiac issues but also other medical and psychosocial aspects such as pregnancy, acquired heart disease, and non-cardiac pathology .
Specialized Care and Research Needs
The increasing prevalence of adult CHD has highlighted the need for specialized centers and multidisciplinary teams to provide comprehensive care . These centers are essential for managing the complex needs of this patient population and ensuring optimal outcomes. Additionally, there is a significant need for dedicated research to better understand the long-term outcomes, survival rates, and comorbidities associated with adult CHD . High-priority research areas include heart failure in tetralogy of Fallot, mechanical circulatory support, sudden cardiac death, and vascular outcomes in coarctation of the aorta.
Conclusion
The landscape of congenital heart disease has dramatically changed, with a growing population of adults living with CHD due to improved survival rates. Lifelong specialized care, regular follow-up, and multidisciplinary management are essential to address the complex needs and long-term complications of these patients. Continued research and the development of specialized centers are crucial to improving the quality of life and outcomes for adults with congenital heart disease.
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