Changing Mortality in Congenital Heart Disease

Khairy, Paul; Ionescu‐Ittu, Raluca; Mackie, Andrew S.; Abrahamowicz, Michał; Pilote, Louise; Marelli, Ariane J.

doi:10.1016/j.jacc.2010.03.085

Cited by 775 publications

(476 citation statements)

References 36 publications

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“…Improved techniques of surgical repair have resulted in larger proportions of women with congenital heart disease achieving reproductive potential. (23,24) Recently the first results of the multicentre European study "Registry on Pregnancy and Cardiac disease" were published. This prospective study included 1 321 pregnancies from 28 countries.…”

Section: Management Of Cardiac Disease In Pregnancymentioning

confidence: 99%

Patient profi le of a tertiary obstetric-cardiac clinic

Merwe

Hall

Herbst

et al. 2017

SAHJ

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relatively fixed combination of factors, can often surprise one. Gestational age at presentation, the unique combination of maternal functional status at a given gestation coupled with the severity of cardiac disease and the known natural course Results: There were 231 women, rheumatic heart disease (n=79; 34.2%) was the predominant cardiac disease followed by congenital heart disease (n=78; 33.8%), medical conditions (n=38; 16.4%) and previous peripartum cardiomyopathy (n=9; 3.9%). Eighty-two women (35.5%) were perceived to be extremely high risk and their entire pregnancies were managed in the Obstetric-Cardiac clinic. The most common RHD lesion was mitral regurgitation (34.2%) and mixed mitral valve disease (24.1%). The most frequent CHD was ventricular septal defects (n=27; 35%). Conclusions: The cardiac disease profi le of patients seen at this obstetric-cardiac clinic in a South African tertiary hospital refl ects a transition from the disease profi le of a typical developing country (high burden of rheumatic heart disease) to the disease profi le seen in a more developed country (high burden of congenital heart disease). This could indicate improved quality of socio-economic development and the health care system. The increasing complexity of cardiac pathology that has to be dealt with in pregnant patients presenting to a tertiary hospital requires close collaboration between the obstetrician, cardiologist, cardiac surgeon and anesthetist caring for these patients. A dedicated obstetric-cardiac clinic is a good model to utilise in a tertiary hospital when aiming to optimise the care of patients with cardiac disease in pregnancy.

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Section: Management Of Cardiac Disease In Pregnancymentioning

confidence: 99%

Patient profi le of a tertiary obstetric-cardiac clinic

Merwe

Hall

Herbst

et al. 2017

SAHJ

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“…Due to advances in surgical repair, the number of women with congenital heart disease (CHD) who survive to childbearing age is increasing [3]. The main pathophysiologic mechanisms in pregnant women with CHD include volume overload, leftto-right shunts, pressure overload, and cyanotic right-to-left shunts [4].…”

Section: Echocardiography In Pregnant Women With Congenital Heart Dismentioning

confidence: 99%

Echocardiography in Pregnancy: Part 1

2016

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The prevalence of pregnant women with cardiovascular heart disease is increasing. Transthoracic echocardiography is safe during pregnancy, and it is an important diagnostic tool in pregnant women with established heart disease in order to monitor ventricular and valvular anatomy and function. In addition, it can be used to delineate cardiac anatomy in complex congenital heart disease and help stratify maternal risk during pregnancy. This review will focus on the use of echocardiography in the diagnosis and management of pregnant women with common congenital lesions and with prosthetic valves.

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“…The idea that prophylactic arrhythmia surgery should be incorporated into reparative open heart procedures stems from the reality that many patients with specific congenital cardiac anatomic substrates are subject to atrial arrhythmia development in the course of their lives, which will impact negatively on ventricular function, physical well being, and long-term survival (1)(2)(3). Patients presenting later in life with any form of atrial septal defect (ASD) have a 30% to 50% incidence of atrial arrhythmias [mostly atrial fibrillation (AF)] with or without operative repair (4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Prophylactic arrhythmia surgery in association with congenital heart disease

Mavroudis

Deal

2016

Transl. Pediatr.

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Certain congenital heart anomalies make patients more susceptible to arrhythmia development throughout their lives. This poses the question whether prophylactic arrhythmia surgery should be incorporated into reparative open heart procedures for congenital heart disease. There is currently no consensus on what constitutes a standard prophylactic procedure, owing to the questions that remain regarding lesions to be performed; energy sources to use; proximity of energy source or incisions to coronary arteries, sinoatrial node, atrioventricular node; circumstances for right atrial, left atrial, or biatrial appendectomy; and whether to perform a right, left, or biatrial maze procedure. These considerations are important because prophylactic arrhythmia procedures are performed without knowing if the patient will actually develop an arrhythmia in his or her lifetime. By reviewing and summarizing the literature, congenital heart disease patients who are at risk for developing atrial arrhythmias can be identified and lesion sets can be suggested in an effort to standardize experimental protocols for prophylactic arrhythmia surgery.

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Changing Mortality in Congenital Heart Disease

Abstract: Deaths in CHD have shifted away from infants and towards adults, with a steady increase in age at death and decreasing mortality.

Cited by 775 publications

References 36 publications

Patient profi le of a tertiary obstetric-cardiac clinic

Patient profi le of a tertiary obstetric-cardiac clinic

Echocardiography in Pregnancy: Part 1

Prophylactic arrhythmia surgery in association with congenital heart disease

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