Sind Erwachsene mit angeborenen Herzfehlern ausreichend versorgt?

Neidenbach, Rhoia; Schelling, Jörg; Pieper, Lars; Sanftenberg, Linda; Oberhoffer, Renate; Haan, Fokko de; Weyand, Michael; Schlensak, Christian; Loßnitzer, Dirk; Nagdyman, Nicole; Kodolitsch, Yskert Von; Kallfelz, H. C.; Helm, P.; Bauer, Ulrike; Ewert, Peter; Meinertz, Thomas; Kaemmerer, Harald

doi:10.1007/s00398-016-0134-x

Cited by 4 publications

(6 citation statements)

References 59 publications

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“…As the number of patients with CHD reaching adulthood is increasing due to improvements in medical and surgical care, a multidisciplinary preventive approach to potentially life-threatening conditions is necessary (35)(36)(37)(38). It is essential to optimize disease awareness in order to encourage patients' self-management.…”

Section: Discussionmentioning

confidence: 99%

Awareness of oral health in adults with congenital heart disease

Hollatz¹,

Wacker-Gußmann²,

Wilberg³

et al. 2019

Cardiovasc. Diagn. Ther.

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Background: Poor oral health is known to be a risk factor for infective endocarditis (IE) and acquired cardiovascular disease. Many patients with congenital heart disease (CHD) are at risk for developing IE.Excellent oral health is deemed essential to prevent IE, a potentially life-threatening condition, and therefore is important in adults with congenital heart defects (ACHD). As data on oral heath in ACHD are scarce, the current study aims to assess the prevalence of caries among ACHD and the knowledge of patients about oral health as a risk factor for IE and cardiovascular disease.Methods: A cross-sectional study included ACHD who subsequently presented at the German Heart Center Munich. The participants completed a questionnaire assessing oral health and risk awareness.Additionally, as an indicator of caries prevalence, a dentist documented the DMFT index (sum of decayed, missing and filled teeth). Results:The median age of the 112 participants was 31.5 (range, 18-77) years. Forty-three patients (38%) were unaware of a correlation between oral health and heart disease. Twelve participants (11%) did not know about poor oral health being a risk factor for cardiovascular diseases. Less than half of the surveyed patients knew the term endocarditis. An additional twelve patients (11%) reported caveats against dental treatment because of their CHD. In twenty-three patients (21%), caries was found at the dentine level. The mean DMFT index, representing caries prevalence, was 7.91 (±6.54). There was no correlation between the Bethesda criteria of CHD and the DMFT index (P=0.69). The DMFT index was higher in patients at high risk for IE (P<0.01). However, this difference in the caries score was mainly due to more extracted and filled teeth in the high-risk patients for IE, whereas the number of decayed teeth did not differ significantly (P=0.09). Conclusions:The awareness of the importance of optimized oral health in ACHD needs to be improved.

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Section: Discussionmentioning

confidence: 99%

Awareness of oral health in adults with congenital heart disease

Hollatz¹,

Wacker-Gußmann²,

Wilberg³

et al. 2019

Cardiovasc. Diagn. Ther.

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“…As the current study data show, this condition particularly affects complex CHD with chronic pressure or volume stress, e.g., univentricular hearts (after Fontan surgery), transposition of the great vessels after atrial switch operation with a systemic right ventricle, as well as pulmonary vascular disease resulting from a primary leftright shunt or severe heart valve disease, e.g., after repair of a Tetralogy of Fallot (22)(23)(24)(25)(26)(27). These patients often respond differently to therapeutic measures than patients with acquired heart disease do (25,27).…”

Section: Acute-and Post-acute Phasementioning

confidence: 94%

“…In principle, the drugs commonly used in adult cardiology are also used for ACHD, although the specific characteristics of CHD must be taken into account (26)(27)(28)(29)(30)(31). Nevertheless, there are many uncertainties regarding therapeutic measures since comprehensive data from controlled studies are lacking (32).…”

Section: Acute-and Post-acute Phasementioning

confidence: 99%

“…In rehabilitation, the detection and treatment of early postoperative cardiac arrhythmias is, therefore, of great importance (4,34). Additionally, it should be known that supraventricular tachycardias are poorly tolerated and can cause decompensation or death, especially in complex CHD (e.g., after atrial inversion, in Fontan circulation, in cyanotic heart defects, in Eisenmenger's syndrome) (27).…”

Section: Acute-and Post-acute Phasementioning

confidence: 99%

“…Also in these patients, the therapy performed has to take the peculiarities of the CHD into account. The use of specific measures and highly effective, but not harmless drugs for pulmonary hypertension treatment, should be coordinated by specialists (26,27,36,39,41) This coordination is particularly true for patients with Eisenmenger's syndrome (42). Supportive therapy measures include treatment with diuretics, oxygen, oral anticoagulants, phlebotomies and compensation for anemia and/or iron deficiency (41,43).…”

Section: Acute-and Post-acute Phasementioning

confidence: 99%

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Lessons from the short- and mid-term outcome of medical rehabilitation in adults with congenital heart disease

Freilinger¹,

Andric²,

Andonian³

et al. 2021

Cardiovasc Diagn Ther

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Background: The number of adults with congenital heart disease (ACHD) is steadily increasing. Over their life-time, many of the affected patients require medical rehabilitation after interventional or surgical treatment of residua, sequels or complications of their congenital heart defect (CHD). However, up to now only scarce data exist about indication, performance and outcomes of cardiac rehabilitation in ACHD. Methods:The course and outcome of rehabilitation after previous interventional or surgical treatment in ACHD was analyzed in a retrospective cohort study.Results: Two hundred and five ACHD {54% female; mean age 34±12 [16-68] years} with mild (23.9%), moderate (35.1%) or severe CHD (41.0%), of whom 32% had complex CHD, 21% right-ventricular outflow tract obstructions, 20% pre-tricuspid shunts, 18% left heart or aortic anomalies, 9% post-tricuspid shunts and 2% other congenital cardiac anomalies were included into analysis. The main indications for rehabilitation were a preceding surgical (92%) or interventional (3%) treatment of the underlying CHD immediately before rehabilitation. During rehabilitation, no severe complications occurred. The number of patients in function class I/II increased from 189 to 200 and decreased in class III/IV from 16 to 5. Cardiac medication could be reduced or stopped after rehabilitation in 194 patients, with the exception of ACEinhibitors. There was an improvement in cardiovascular risk factors. While before medical treatment 77% (n=157) patients were capable of working, the number increased to 82% [168] at the end of rehabilitation.Throughout a follow-up 9.3% (n=19) of patients needed further cardiac interventions. Conclusions:The current study provided for the first time comprehensive data on the course of rehabilitation in a large cohort of ACHD after surgical or interventional treatment. The overall outcome of ACHD after rehabilitation was uneventful and favorable. Further research is required to assess the clinical long-term outcome, the impact of rehabilitation on the quality of life, disease coping and employment. The results of this study can serve as a benchmark for the development of specific rehabilitation programs in ACHD.

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