Extracardiac Complications in Adults with Congenital Heart Disease

Abstract

With the increasing number of adults living with repaired, or unrepaired, congenital heart disease, there is a growing incidence of extracardiac comorbidities. These comorbidities can affect various organ systems in complex ways, and may have a significant impact on a patient's quality of life and survival. Many of these potential complications may go undiagnosed until there is already a significant bearing on the patient's life. Therefore, it is important for physicians who care for the adult congenital patient to be mindful of these potential extracardiac complications, and actively assess for these complications in their adult congenital practice. Continued research to identify modifiable risk factors is needed so that both preventative and therapeutic management options for these extracardiac complications may be developed.

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

“…58 Forty-four percent of adults with CHD demonstrated a pattern on spirometry suggestive of restrictive lung disease, which is markedly higher than the 9% prevalence in the general adult population. 59 The prevalence of restrictive lung disease was highest in patients with a history of Fontan procedure (89%) and tetralogy of Fallot (TOF) repair (76%).…”

“…58 The higher prevalence of restrictive lung physiology in adults with CHD is often secondary to an extrinsic pulmonary cause. The chest wall is an important component of normal respiratory function, and multiple thoracotomies can lead to a restrictive thoracic cage, which in turn disrupts normal chest wall mechanics and respiratory function.…”

Veleszületett szívhibák sebészi kezelése 60 éves kor felett

“…Az időskorú betegeknél megnövekszik rizikófaktor-ként az extracardialis komorbiditás [24]. Májelégtelen-ség kialakulása jól dokumentált jobbszívfél-elégtelenség esetén [25].…”

“…Májelégtelen-ség kialakulása jól dokumentált jobbszívfél-elégtelenség esetén [25]. Fontan-betegeknél a magas centrális vénás nyomás, "low cardiac outpout", megelőző többszöri műtéti beavatkozás miatt májelégtelenség, cirrhosis fejlődik ki [24][25][26]. A betegek 9%-ában, különösen cyanoticus, Eisenmenger-szindrómás betegeknél, veseelégte-lenség alakul ki [27].…”

“…A betegek 9%-ában, különösen cyanoticus, Eisenmenger-szindrómás betegeknél, veseelégte-lenség alakul ki [27]. E betegeknél nagyszámú a tüdő restruktív megbetegedése is [24,28].…”