المؤلفون: David S. Celermajer, Irina Kotchetkova, Rajan Rehan, Rachael Cordina

المصدر: Heart, lungcirculation. 30(2)

مصطلحات موضوعية: Pulmonary and Respiratory Medicine, Aortic valve, Adult, Heart Defects, Congenital, Male, medicine.medical_specialty, Heart disease, Adolescent, Coarctation of the aorta, 030204 cardiovascular system & hematology, Implantable defibrillator, 03 medical and health sciences, Electrocardiography, Young Adult, 0302 clinical medicine, Internal medicine, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, Survivors, Depression (differential diagnoses), Tetralogy of Fallot, business.industry, Middle Aged, medicine.disease, Middle age, Survival Rate, medicine.anatomical_structure, Heart failure, Cardiology, Quality of Life, Female, New South Wales, Cardiology and Cardiovascular Medicine, business

الوصف: Background Although advances in congenital heart disease (CHD) management have allowed survival of children with even highly complex CHD lesions well into adult life, the burden of disease (medical, psychological and social) has not been well characterised, for those living to middle age and beyond. Methods We assessed 121 consecutive patients from our adult CHD centre, who survived to age 50 years and who had had moderate or complex CHD lesions. Pre-specified groups included those with repaired tetralogy of Fallot (TOF) (n=56), coarctation of the aorta (CoA) (n=34), systemic right ventricle (RV) (n=9), Fontan surgery for “single ventricle” hearts (n=5), those with repaired Ebstein's Anomaly (n=9) and other complex CHD (n=8). Results The overall burden of disease was very substantial. Of the TOF patients, almost half (46%) had required at least one open-heart reoperation and 41% had had a pacemaker or implantable defibrillator; 20% had had a radiofrequency ablation and 32% were on anti-arrhythmic therapy. Over 40% had ≥1 admission for heart failure and 9% had had endocarditis. Only 64% were still employed. Of the CoA survivors, 50% had had a second operation (aortic valve and/or descending aortic surgery), 88% were on medications for hypertension and 62% were still employed. In the more complex groups, approximately half had been diagnosed with depression/anxiety and cerebrovascular event, heart failure and/or significant arrhythmias were common. Conclusions Despite considerable advances, adults with CHD who survive to age 50 years have experienced high levels of physical and mental health complications.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c25948a0305fa0010b0861cc75051f66
https://pubmed.ncbi.nlm.nih.gov/32713766