2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Stout, Karen; Daniels, Curt J.; Aboulhosn, Jamil; Bozkurt, Biykem; Broberg, Craig S.; Colman, Jack M.; Crumb, Stephen R.; Dearani, Joseph A.; Fuller, Stephanie; Gurvitz, Michelle; Khairy, Paul; Landzberg, Michael J.; Saïdi, A.; Valente, Anne Marie; Hare, George F. Van

doi:10.1161/cir.0000000000000603

Cited by 807 publications

(1,274 citation statements)

References 692 publications

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“…Thus, our study demonstrates an unmet need among men and suggests that balanced family planning counseling should be provided to both men and women with CHD. Information should be provided about contraception options, risks to the patient and offspring, and sexual health, and ideally as part of a formal patient education curriculum …”

Section: Discussionmentioning

confidence: 99%

“…Study procedures included completion of a questionnaire and medical record review. Disease complexity was designated as simple, moderate, or great according to guidelines . If patients had more than one CHD lesion, they were categorized according to the lesion of highest severity.…”

Section: Methodsmentioning

confidence: 99%

“…As patients reach adulthood, they may face potential challenges including employment, acquisition and maintenance of health insurance, and family planning. The 2018 American College of Cardiology/American Heart Association Guidelines for the Management of Adults with CHD recommend addressing insurance barriers and issues of contraception, pregnancy, and sexual health …”

Section: Introductionmentioning

confidence: 99%

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Too little too late? Communication with patients with congenital heart disease about challenges of adult life

Deng

Gleason

Awh

et al. 2019

Congenital Heart Disease

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Objective To investigate the experiences and communication preferences of adult patients with congenital heart disease (CHD) in the domains of employment, insurance, and family planning. Design Patients ≥ 18 years of age completed a questionnaire about experiences and communication preferences regarding employment, health insurance, and family planning. Results Of 152 patients (median age = 33 years, 50% female, 35% with CHD of great complexity), one in four reported work‐related problems due to CHD and a quarter also recalled a previous gap in health insurance. Of females, 29% experienced an unplanned pregnancy. The median importance of discussion ratings (on a 0‐10 scale) were 3.5 (employment), 6.0 (insurance), and 8.0 (family planning). Few patients recalled discussions about employment (19%) or health insurance (20%). Over half recalled discussions about family planning, although males were less likely to have had these discussions than females (24% vs 86%, P < .001). Across the three domains, patients identified 16‐18 years as the most appropriate age to initiate discussion, although for patients who recalled discussions, they typically occurred between 20 and 25 years. Conclusions Adults with CHD commonly face employment, health insurance, and family planning challenges. However, discussions about these matters occur with less frequency than recommended and at older ages than patients would prefer. Communication about such issues should be incorporated into a comprehensive educational curriculum for adolescents during the process of transition to adult care.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Too little too late? Communication with patients with congenital heart disease about challenges of adult life

Deng

Gleason

Awh

et al. 2019

Congenital Heart Disease

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“…[14][15][16] Although, CAD is an expected morbidity that occurs with aging, there is still very little research on CAD outcomes in the aging was not designed or powered to determine the specific cause of LV dysfunction (as some patients might have LV dysfunction due to previous cardiac surgery unrelated to their CAD diagnosis) or the impact of LV dysfunction on CAD outcomes, we speculate that perhaps, early detection and revascularization may improve survival in these patients. [14][15][16] Although, CAD is an expected morbidity that occurs with aging, there is still very little research on CAD outcomes in the aging was not designed or powered to determine the specific cause of LV dysfunction (as some patients might have LV dysfunction due to previous cardiac surgery unrelated to their CAD diagnosis) or the impact of LV dysfunction on CAD outcomes, we speculate that perhaps, early detection and revascularization may improve survival in these patients.…”

Section: Discussionmentioning

confidence: 99%

Coronary artery disease in adults with tetralogy of Fallot

Egbe

Ananthaneni

Jadav

et al. 2019

Congenital Heart Disease

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Background:There are limited data about outcomes of coronary artery disease (CAD) in adults with repaired tetralogy of Fallot (TOF). The purpose of this study was to describe the prevalence and treatment of CAD in adults with TOF, and the impact of CAD on long-term survival.Methods: Retrospective review of MACHD database for adults with repaired TOF who underwent aortic root/selective coronary angiogram, 1990-2017. Patients were categorized into three groups: (1) No CAD defined as normal coronary angiogram; (2) Mild CAD defined as ≤50% stenosis in all vessels; and, (3) Significant CAD defined as >50% stenosis in any vessel. Results:We identified 105 (23%) of 465 TOF patients that had angiograms; mean age 47 ± 12 years. The prevalence of mild CAD and significant CAD was 19% (20 patients) and 15% (16 patients), respectively. Of these 16 patient with significant CAD, 9 (56%), 3 (19%), and 4 (24%) patients received guideline directed medical therapy, percutaneous coronary intervention, and coronary artery bypass grafting, respectively. Significant CAD was an independent risk factor for mortality (HR: 2.03, 95% CI 1.64-4.22, P = .022) after adjustment for differences in age, and prevalence of atrial fibrillation and renal dysfunction.Conclusions: Based on a review of a selected cohort of 105 TOF patients, the prevalence of mild CAD and significant CAD was 19% and 15%, respectively. Significant CAD was an independent risk factor for mortality. There is need for more research to determine optimal noninvasive diagnostic strategies and optimal patient selections and methods for revascularization. K E Y W O R D Scoronary artery disease, coronary intervention, tetralogy of Fallot

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“…The need for genetic considerations in the field of adult CHD (ACHD) is only increasing, and professional communities are acknowledging this need. The 2018 American Heart Association/American College of Cardiology guidelines for the management of adults with CHD recommended genetics (including genetic counseling from genetic counselors) as one of the multidisciplinary services needed for programs focused on the care of adult patients with CHD (Stout et al, ). In addition, the European Society of Cardiology emphasized the importance of counseling in genetic testing in adult patients with CHD (De Backer et al, ).…”

Section: Introductionmentioning

confidence: 99%

Genetic considerations for adults with congenital heart disease

Ito

Kisling

John

2020

American J of Med Genetics Pt C

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Congenital heart disease (CHD) remains the most common birth defect, with an estimated incidence of approximately 1% of all births. The population of adults with CHD is growing rapidly with advances in medical care. Overall survival to adulthood in the current era estimated to exceed 90%. Genetic causes of CHD can be classified into several broad categories: (a) chromosomal aneuploidy, (b) large chromosomal deletion or duplication, (c) single gene mutation, and (d) copy number variation. However, only 20–30% of CHD cases have an established etiology characterized by either genetic abnormalities or environmental factors. The role of genetics in the field of adult CHD is only increasing. More adult patients with CHD are seeking genetic counseling to understand the etiology of their underlying CHD and the risks to future offspring. A multidisciplinary approach is essential to provide appropriate counseling to patients regarding indications for genetic testing and interpretations of results. Novel advances with precision medicine may soon enable clinicians to individualize therapies for a comprehensive approach to the care of adult patients with CHD.

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2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Cited by 807 publications

References 692 publications

Too little too late? Communication with patients with congenital heart disease about challenges of adult life

Too little too late? Communication with patients with congenital heart disease about challenges of adult life

Coronary artery disease in adults with tetralogy of Fallot

Genetic considerations for adults with congenital heart disease

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