Adult congenital heart disease: Past, present and future

Acta Paediatr. 2019 Oct;108(10):1757-1764. doi: 10.1111/apa.14921. Epub 2019 Aug 18.

Abstract

The diagnosis and management of congenital heart disease (CHD), the most common inborn defect, has been a tremendous success story of modern medicine. In the 1950s, survival of children born with CHD was only approximately 15%, whereas nowadays more than 90% of these children survive well into adulthood. Consequently, the prevalence of patients with CHD has shifted away from infancy and childhood towards adulthood. Adult CHD cardiology is now encompassing not only young or middle-aged adults but also patients with CHD over 60 years old. Many adult patients are afflicted by residual haemodynamic lesions and also face additional opportunities and/or challenges such as pregnancy, acquired heart disease, non-cardiac pathology etc., necessitating integrated care and all medical disciplines. We are faced with a "tsunami" in terms of adult CHD numbers, disease heterogeneity and complexity of work and interventions needed. We need to secure resources, welcome more people in our field, learn from "marching with our patients", and educate better patients, public and ourselves so that every single patient with CHD, born anywhere in the world, may reach their full life potential.

Keywords: adult congenital heart disease; catheter interventions in congenital heart disease; history of congenital heart disease; surgery in congenital heart disease.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Adult
  • Cardiology / history*
  • Cardiology / trends
  • Heart Defects, Congenital / surgery*
  • History, 20th Century
  • Humans