Task Force 1: the changing profile of congenital heart disease in adult life

Warnes, Carole A.; Liberthson, Richard R.; Danielson, Gordon K.; Dore, Annie; Harris, Louise; Hoffman, Julien I.E.; Somerville, Jane; Williams, Roberta G.; Webb, Gary D.

doi:10.1016/s0735-1097(01)01272-4

Cited by 1,273 publications

(945 citation statements)

References 6 publications

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“…Such an increase might continue until the prevalence is close to the incidence of CHD at birth adjusted by optimized survival. In 2014, the prevalence of ACHD in our study was 2.17 per 1000 adults, which is within the previous reported estimated range (1.7–6.12 per 1000) 1, 3, 4, 5, 6. In most high‐income countries in which care for ACHD is increasingly structured, prevalence of severe ACHD would increase over time 3, 4, 11.…”

Section: Discussionsupporting

confidence: 84%

“…Data of ACHD prevalence may also be estimated from CHD incidence at birth and survival estimate for each type of CHD. By using this approach, prevalence of ACHD was estimated to be between 1.77 and 4.91 per 1000 adults in 6 high‐income countries between 2001 and 2011 2, 5, 6, 7. Prevalence of ACHD is generally lower than incidence of CHD at birth for the following reasons: (1) case mortality; (2) loss of follow‐up because of spontaneously resolved CHD or asymptomatic surgically repaired CHD; and (3) poor adherence to medical follow‐up schedules.…”

Section: Introductionmentioning

confidence: 99%

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Adult Congenital Heart Disease in a Nationwide Population 2000–2014: Epidemiological Trends, Arrhythmia, and Standardized Mortality Ratio

Chen

et al. 2018

JAHA

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BackgroundThe adult congenital heart disease (ACHD) population will grow with medical advances, but data are limited. We investigated the epidemiological profile of ACHD in Taiwan, a country with a congenital heart disease program since 1955, population of 23 million, and easily accessible high‐standard medical care.Methods and Results ACHD patients, born after 1954, were identified from the nationwide database 2000–2014. The ACHD prevalence in the population aged 18 to 59 was 140.53, 157.08, 182.45, and 217.00 per 100 000 in 2000, 2005, 2010, and 2014, respectively (increasing time trend, P<0.0001). Percentage of severe ACHD also increased over time (P<0.0001) and was 11.70% in 2014. The 5 leading ACHD diagnoses were ventricular septal defect, secundum atrial septal defect, patent ductus arteriosus, pulmonary stenosis, and tetralogy of Fallot. Freedom from tachyarrhythmia at age 50 years was 0.574 and 0.710 for severe and simple ACHD, respectively. Cardiac causes accounted for the majority of deaths, followed by malignancy in simple ACHD and external causes/sudden death/out‐of‐hospital death in severe ACHD patients. The proportion of unexpected death was 10%. Compared with the general population, the standardized mortality ratio was higher not only in severe ACHD (3.164; 95% confidence interval, 2.664–3.664), but also in women with simple ACHD (1.704; 95% confidence interval, 1.499–1.909), with a higher proportion of cardiac, labor, and sudden death as causes of death.ConclusionsWe demonstrated an increasing trend in ACHD prevalence and medical complexity. They are at risk of tachyarrhythmia, higher mortality, and unexpected deaths, suggesting a gap in their medical care.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Adult Congenital Heart Disease in a Nationwide Population 2000–2014: Epidemiological Trends, Arrhythmia, and Standardized Mortality Ratio

Chen

et al. 2018

JAHA

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“…[1] In the modern era of advanced surgical techniques and postoperative care and management, more than 90% of children with congenital heart disease (CHD) will reach adulthood. [2], [3] The successful outcomes of the earlier surgical era have resulted in an ever-increasing number of adults with CHD. As of 2011, more adults than children are alive with CHD.…”

Section: Introductionmentioning

confidence: 99%

Atrial Fibrillation in Patients with Congenital Heart Disease

Moe

Abrich

Rhee

2017

Journal of Atrial Fibrillation

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“…1,2 The outcome for VSD is usually excellent, and almost all patients are expected to reach childbearing age. 3,4 Despite the fact that a VSD is one of the most common forms of heart disease among pregnant women, VSD-specific pregnancy data are limited.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy outcome in women with repaired versus unrepaired isolated ventricular septal defect

Yap

Drenthen

Pieper

et al. 2010

BJOG

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Objective To compare the risks of pregnancy complications in women with repaired and unrepaired isolated ventricular septal defect (VSD).Design A retrospective multicentre study.Setting Tertiary centres in the Netherlands and Belgium.Methods Women were identified using two congenital heart disease registries. Eighty-eight women were identified who had experienced 202 pregnancies, including 46 miscarriages and nine terminations of pregnancy. Information on each completed pregnancy (n = 147; unrepaired VSD, n = 104; repaired VSD, n = 43) was obtained using medical records and telephone interviews. Data from the Generation R database (prospective cohort study; n = 9667) were used to determine the background risk (controls). Odds ratios and 95% CI were estimated using general estimation equation analysis adjusted for multiple pregnancies per woman, maternal age and parity status.Main outcome measures Adjusted odds ratios (AORs) for developing pregnancy complications in relation to corrective status.Results Pregnancies in women with an unrepaired VSD were associated with a higher risk of pre-eclampsia (AOR 4.59, 95% CI 2.01-10.5, P < 0.001) compared with controls. No differences were observed when comparing women with repaired VSD and controls. Pregnancies in women with repaired VSD were associated with a higher risk of premature labour (AOR 4.02, 95% CI 1.12-14.4, P = 0.03) and small-for-gestational-age (SGA) births (AOR 4.09, 95% CI 1.27-13.2, P = 0.02) compared with women with unrepaired VSD.Conclusions Women with unrepaired VSD are at increased risk of pre-eclampsia, which suggests that it is not a benign condition. In addition, women with repaired VSD are at increased risk of premature labour and SGA births compared with women with unrepaired VSD.

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Task Force 1: the changing profile of congenital heart disease in adult life

Cited by 1,273 publications

References 6 publications

Adult Congenital Heart Disease in a Nationwide Population 2000–2014: Epidemiological Trends, Arrhythmia, and Standardized Mortality Ratio

Adult Congenital Heart Disease in a Nationwide Population 2000–2014: Epidemiological Trends, Arrhythmia, and Standardized Mortality Ratio

Atrial Fibrillation in Patients with Congenital Heart Disease

Pregnancy outcome in women with repaired versus unrepaired isolated ventricular septal defect

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