Key result
Adult congenital heart disease management is evolving, showing low-risk patients have complication rates similar to the general population and comparable outcomes with advanced therapies.
Why the study?
To review new developments in adult congenital heart disease patients across imaging, percutaneous interventions, ventricular assist devices, and transplantation.
Advances in ACHD management show that low-risk patients have comparable outcomes to the general population, emphasizing the need for tailored risk stratification in anesthesia and surgery.
May support tailored anesthesia risk stratification in low-risk ACHD; leaves open prospective validation of advanced therapies.
PURPOSE OF REVIEW: The current review focuses on the new development of adult congenital heart disease (ACHD) patients in the areas of imaging, percutaneous interventions, ventricular assist devices and transplantation. RECENT FINDINGS: Since the last ACHD publication in the journal, several advances have been made in the evaluation and treatment of these patients. As CHD patients' longevity increases pregnancy, comorbities and acquired heart disease become a concern. Recent data show that the incidence of complications in low-risk CHD is not higher that the regular population. In addition, breakthrough research in percutaneous valve implantation has been published showing good outcomes but needing intensive care recovery in a significant number of patients. In the ACHD heart failure population, assist device and transplant fields mounting evidence shows that these therapies should not be the last resort since low-risk ACHD patient may have similar outcomes to those with acquired heart disease. Finally risk stratification is important in ACHD to define better ways to recover from surgery and anesthesia. SUMMARY: The field of anesthesia for ACHD is growing with new indications for diagnostic, interventional and surgical procedures. Tailoring cardiac and noncardiac care to the different risk profile in ACHD patients will be defined in the next few years. VIDEO ABSTRACT: Motta summary clip: http://links.lww.com/COAN/A65.
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Motta et al. (2020) conducted a review in Adult congenital heart disease. Adult congenital heart disease management is evolving, showing low-risk patients have complication rates similar to the general population and comparable outcomes with advanced therapies.
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