Therapeutic consideration for grown-up congenital heart disease


Heart 1

With exceptions, medical management is largely supportive for heart failure, arrythmias, pulmonary and systemic arterial hypertension, prevention of thrombo-embolic events, or endocarditis. Significant structural abnormalities usually require interventional treatment.

Heart failure:

Heart failure is a frequent problem in the grown-up congenital heart disease population.  However, as the pathophysiology of cardiorespiratory dysfunction is often very different from the failing normal circulation,  particularly in settings such as transposition of the great arteries with arterial switch repair

Arrhythmias and sudden cardiac death:

Arrhytmias are the main reason for the hospitalization of grown-up congenital heart disease patient and they are an increasingly frequent cause of morbidity and mortality. Furthermore, the onset of arrythmyas may be a signal of haemodynamic decompensation, and the risk associated with arrhytmias may be amplified in the presence of the often abnormal underlying circulation.

Sudden cardiac death is of particular concern in grown-up congenital heart disease. The  defects with the…

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