Resynchronization Therapy for Patients with Congenital Heart Disease: Are We Ready for Prime Time?

Anjewierden, Scott; Aziz, Peter F.

doi:10.1007/s11886-018-1015-6

Cited by 7 publications

(2 citation statements)

References 68 publications

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“…In contrast, a lateral thoracotomy may provide surgeons with access to pristine tissue. Finally, CRT devices are not MRI compatible, which limits later imaging options in the long‐term management of younger patients …”

Section: End‐stage Congenital Heart Disease—the Next Big Challengementioning

confidence: 99%

Adult congenital heart disease: Past, present and future

Brida

Gatzoulis

2019

Acta Paediatrica

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The challenge is great; the rewards are enormous. For me there have been few things in life which have been more satisfying than to face a small child, struggling for his very existence, to perform some corrective surgical maneuver, and later to see the youngster, thriving and healthy, starting out in life, sound in body and mind.Robert Edward Gross 'father of cardiac surgery' | INTRODUC TI ONThe diagnosis and management of congenital heart disease (CHD), the most common inborn and global defect, has been a tremendous success story of modern medicine. Back in the 1950s, survival of children born with CHD was only approximately 15%. Thanks to remarkable advances in paediatric cardiology, cardiac surgery and catheter interventions, including radical and innovative procedures such as atrial/arterial switch for transposition of great arteries (TGA), the Fontan operation for "single ventricle", percutaneous pulmonary valve implantation and others, more than 90% of children survive now well into adulthood ( Figure 1). 1 Residual and progressive haemodynamic lesions, exercise intolerance, arrhythmias, heart failure (HF) and premature death, however, afflict many patients. 2 Beyond CHD, adult patients face additional opportunities and/or challenges such as pregnancy, acquired heart disease, non-cardiac pathology, necessitating integrated care and most if not all medical disciplines. Furthermore, there is a pressing need to understand better the late pathophysiology of CHD and provide evidence regarding drug therapy, devices and transplantation. 3 We are truly faced with a "tsunami" in terms of adult CHD numbers, disease heterogeneity and complexity of work and intervention/s needed. We must work together, beyond age and geographic boundaries to provide

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Section: End‐stage Congenital Heart Disease—the Next Big Challengementioning

confidence: 99%

Adult congenital heart disease: Past, present and future

Brida

Gatzoulis

2019

Acta Paediatrica

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“…A retrospective review on 20 patients with congenitally corrected transposition of the great arteries reported that CRT implantation is feasible, and that the long-term outcome is favorable but linked to systematic morphologic RV dysfunction in some patients [42]. Since most of the studies available are retrospective in nature, the impact of CRT on long-term prognosis in this population is still unknown [43, 44]. …”

Section: Concomitant Cardiac Conditionsmentioning

confidence: 99%

Cardiac Resynchronization Therapy Optimization: A Comprehensive Approach

et al. 2019

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Since the first report on biventricular pacing in 1994, cardiac resynchronization therapy (CRT) has become standard for patients with advanced heart failure (HF) and ventricular conduction delay. CRT improves myocardial function by resynchronizing myocardial contraction, which results in reverse left ventricular remodeling and improves symptoms and clinical outcomes. Despite the accelerated development of CRT device technology and its increased application in treating HF patients, almost one-third of these patients do not respond to the therapy or gain any clinical benefit from device implantation. Over the last decade, multiple cardiac imaging modalities have provided a deeper understanding of myocardial pathophysiology, thereby improving HF treatment management. However, the optimal strategy for improving the CRT response remains debatable. This article provides an updated overview of the electropathophysiology of myocardial dysfunction in ventricular conduction delay and the diagnostic approaches involving the use of multiple modalities.

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General principles of heart failure management in adult congenital heart disease

Tompkins

Romfh

2019

Heart Fail Rev

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Resynchronization Therapy for Patients with Congenital Heart Disease: Are We Ready for Prime Time?

Cited by 7 publications

References 68 publications

Adult congenital heart disease: Past, present and future

Adult congenital heart disease: Past, present and future

Cardiac Resynchronization Therapy Optimization: A Comprehensive Approach

General principles of heart failure management in adult congenital heart disease

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