The Adult With Congenital Heart Disease: Born To Be Bad?

摘要: The population of patients with adult congenital heart disease is approximately 800,000 in the U.S. Those prior cardiac surgery often consider themselves “cured,” although majority faces a lifetime problems including arrhythmias, ventricular dysfunction, and one or more re-operations. Even repaired “simple” lesions such as an atrial septal defect may not have normal survival if they are adulthood. Patients coarctation premature cardiovascular complications sudden death, myocardial infarction, stroke. They also aortic aneurysm dissection, which result from diffuse arteriopathy continued hypertension that be caused by underlying endothelial dysfunction. In addition, bicuspid valve occurs than one-half coarctation, so surveillance for significant valvular necessary. More complex pose after “total correction.” tetralogy Fallot pulmonary regurgitation, frequently overlooked on clinical exam echocardiography. Pulmonary replacement should performed before development irreversible right dysfunction increased risk tachycardia death. Because vulnerable to deterioration systemic function, those congenitally corrected transposition require special vigilance, usually concomitant atrio-ventricular regurgitation. Late referral common deleterious effect long-term survival. These need lifelong follow-up residua sequelae their anomalies must understood order provide optimum care.