Natural History of Congenital Heart Disease

Abstract

It is difficult to make prognoses and decisions on therapy of individuals with congenital heart disease (CHD) and plan efficiently for medical services and training programs because studies on the incidence and relative frequency of different types of CHD at birth, mortality rates, times of death, and prevalence rates in children and adults are incomplete or unrepresentative. The present study assesses the merits of previous surveys and attempts to indicate the best information about these rates. Specific attention has been directed to data on ventricular septal defect (VSD), with an estimated incidence of at least 20/10,000 live births; about 10% of these children died before 15 years of age. There should thus be about 18/10,000 surviving school children with VSD, yet the most intensive school surveys show only about half this number. This supports the suggestion that there is a high incidence (perhaps 50%) of spontaneous closure of VSD during childhood. Spontaneous closure may also occur frequently after childhood, but this conclusion needs to be confirmed by better surveys.

Prevalence of congenital anomalies in newborns with congenital heart disease diagnosis

“…[1234567] Depending on the severity of CHD diagnosis, the clinical course may range from spontaneous closure of defect as seen with small septal defects to a lifelong need for medical and surgical interventions. [89] The presence of non-cardiac CAs also significantly impacts the natural history and clinical course of CHD as these patients may require medical and/or surgical interventions independent of their cardiac pathology.…”

Implante transcateter de bioprótese valvular pulmonar: revisão sistemática da literatura

“…[1][2][3] The conduits used in the surgical correction of RV outflow tract dysfunctions frequently develop regurgitation and/or progressive stenosis requiring multiple surgeries, which result in significant mobility and mortality in these patients. [1][2][3] The Melody  valve prosthesis, developed by Bonhoeffer et al 7 to be percutaneously implanted, brought considerable benefits to patients with dysfunctions in the RV outflow tract, as it simultaneously corrects pulmonary insufficiency and stenosis. A significant decrease in RV systolic pressure can be observed when using this valved device, due to stenosis relief in its outflow tract, also determining are duction or abolition of pulmonary reflow in those cases with predominant regurgitation.…”

“…7,8 The technique was originally developed to limit the need for multiple surgical procedures, ultimately replacing a new surgical valve exchange. 1 Subsequent studies confirmed the safety and efficacy of this technique, 4,8 which has been used in over 1,000 patients in the world, especially in Europe. 9 As it occur with the less prevalent diseases, to date there have been no prospective, randomized trials with a large number of patients to definitively guide the treatment of dysfunction in these conduits in the RV outflow tract.…”

“…Ross procedure, used for reconstruction of the left ventricular outflow tract in case of double aortic lesion, also involves this strategy. Although these reconstructive surgeries of the right outflow tract ventricle can be performed with low mortality, 1 the duration of the implanted valves or conduits is usually small (< ten years), due to degeneration and/or calcification of the materials used for their manufacture. Varying degrees of pulmonary stenosis, most often associated to pulmonary failure, are the result of conduit degeneration.…”

“…The earlier the interposition is performed; the lower is the durability of the conduit. Such observation results in the need to perform several open-heartsurgeries, 1 which have great impact on patients' health and quality of life, especially in the case of children. In addition, a new pulmonary valve replacement surgical requires the use of cardiopulmonary bypass (CPB), which can worsen the RV function, usually already compromised.…”