Epidemiology and Mortality in Adult Congenital Heart Disease
Most surgical techniques for complex congenital heart lesions have undergone continuous modification from their invention to the current era. These modifications include both the surgical technique itself, but also the timing of surgical repair. Thus, the cohorts of adult CHD survivors, particularly of survivors with complex congenital heart lesions, are just emerging and the number and demographic characteristics of these survivors will change over the next few decades.
Despite dramatic improvements in life expectancy, most survivors of infant heart surgery for CHD are not cured. Many are at risk for cardiovascular complications, such as arrhythmias or heart failure, and some will require reoperation or reintervention. In particular, survivors of complex CHD are at risk of premature death as adults, albeit the extent of excess mortality is not well defined. With aging of these cohorts complication rates and mode of death are likely to substantially change over the next few decades. Within this article we anticipate some of these developments and outline future challenges in the care of adults with CHD.
Evolution of the Current Patient Populations at Risk of Premature Death
Most surgical techniques for complex congenital heart lesions have undergone continuous modification from their invention to the current era. These modifications include both the surgical technique itself, but also the timing of surgical repair. Thus, the cohorts of adult CHD survivors, particularly of survivors with complex congenital heart lesions, are just emerging and the number and demographic characteristics of these survivors will change over the next few decades.
Despite dramatic improvements in life expectancy, most survivors of infant heart surgery for CHD are not cured. Many are at risk for cardiovascular complications, such as arrhythmias or heart failure, and some will require reoperation or reintervention. In particular, survivors of complex CHD are at risk of premature death as adults, albeit the extent of excess mortality is not well defined. With aging of these cohorts complication rates and mode of death are likely to substantially change over the next few decades. Within this article we anticipate some of these developments and outline future challenges in the care of adults with CHD.
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