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British Medical Bulletin 2008 85(1):151-180; doi:10.1093/bmb/ldn005
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© The Author 2008. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Adult congenital heart disease: a 2008 overview

Elisabeth Bédard1,2, Darryl F. Shore1,2 and Michael A. Gatzoulis1,2,*

1 Adult Congenital Heart Center and Center for Pulmonary Arterial Hypertension, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
2 National Heart and Lung Institute, Imperial College, London, UK

* Correspondence to: Michael A. Gatzoulis, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. E-mail: m.gatzoulis{at}rbht.nhs.uk

Introduction: During the past decades, health care of patients born with congenital heart disease (CHD) has improved substantially, leading to a growing population of adult survivors.

Source of data: Using the recently published and relevant data on adult CHD (ACHD), we reviewed the most common congenital heart defects and discussed important related issues.

Areas of agreement: Adults with CHD most often require specialized medical or surgical care in a tertiary centre. However, this population also need local follow-up; general practitioners and other specialists therefore have to face the complexity of their disease.

Areas of controversies: Management of pregnancy, non-cardiac surgery, arrhythmias and endocarditis prophylaxis may be challenging in patients with CHD and should be adapted to their condition.

Growing points: The present article summarizes key clinical information on ACHD for the benefit of physicians who are not specialized in this field.

Areas timely for developing research: Research efforts and education strategies are greatly needed in order to optimize the care of patients with ACHD.

Keywords: Congenital • heart • adult

Accepted for publication January 21, 2008.


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