General Concepts in Adult Congenital Heart Disease

Abstract

Congenital heart disease in adults (adult congenital heart disease) is a growing burden for healthcare systems. While infant mortality due to congenital heart disease in the last four decades decreased by almost 3-fold, adult congenital heart disease prevalence increased by more than 2-fold in United States. Adult congenital heart disease prevalence is expected to increase steadily until 2050 in projections. Adult congenital heart disease is a multifaceted problem with many dimensions. This manuscript aims to provide an overview of the common adult congenital heart diseases and summarize important points in management of these diseases with possible problems and complications that the patients and the physicians face.

Keywords: Adult; concepts special.; congenital heart disease; general.

Figure 1. Adapted from (2)]: Projected growth of the adult congenital heart disease population in the United States to the year 2050. Upper graph with the red trajectory shows the estimated number of cases, while the lower graph with the dotted green trajectory shows the estimated prevalence. Case numbers and prevalence shows a hyperbolic increase with a plateau in the 2050s.

Figure 2. MRI quantification of pulmonary regurgitation. In this patient the regurgitation fraction was calculated as 17% by flow analysis.

Figure 3. Three-dimensional imaging of aorta in a patient with previous bare stent implantation for aortic coarctation.

Figure 4. Holter recording in a patient with previous atriopulmoanry Fontan. There is atrial tachycardia with slow ventricular rhythm.

Figure 5. Kawashima operation in a patient with single ventricle physiology. There is narrowing at the proximal part of the left pulmonary artery.

Figure 6. Magnetic resonance imaging of the right ventricle and pulmonary regurgitation in a patient with tetralogy repair. The right ventricle is enlarged and regurgitant jet (black arrow) is seen.

Figure 7. Wide QRS tachycardia in a patient with previous repair of tetralogy. The patient underwent a cardiac electrophysiologic study and an implantable cardioverter defibrillator was implanted.

Figure 8. Baffle obstruction over vena cava superior connection in a patient with previous Senning operation (atrial switch) (white arrow).