Adult Congenital Heart Disease Management
Summary
Advances in paediatric cardiology and surgery have transformed congenital heart disease into a chronic condition of adulthood, resulting in a growing and ageing cohort of patients. Management of adult congenital heart disease encompasses lifelong surveillance, regular imaging, timely intervention and coordinated multidisciplinary care. Risk stratification now integrates anatomical complexity, prior palliative procedures and functional status to guide personalised follow-up intervals. Modern imaging techniques—such as cardiac magnetic resonance and three-dimensional echocardiography—enhance assessment of ventricular function, residual shunts and valve performance. Electrophysiological surveillance addresses arrhythmia risks, while heart failure therapies and catheter-based valve interventions broaden treatment options for systemic right ventricles and single-ventricle physiology. Specialised pregnancy programmes and transition services facilitate safe maternal care and smooth transfer from paediatric to adult centres. Across healthcare systems, emphasis is placed on patient empowerment, mental health support and the seamless integration of primary and specialist services to optimise long-term outcomes.
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Adult Congenital Heart Disease Management publication trend
The graph below shows the total number of articles in adult congenital heart disease management across all publications each year (not limited to Nature Index journals).
Technical terms
Congenital heart disease (CHD): A range of structural cardiac anomalies present at birth, varying from simple septal defects to complex malformations.
Systemic right ventricle: A morphological right ventricular chamber supporting systemic circulation, typically after atrial switch or congenitally corrected transposition.
Palliative intervention: Procedures aimed at relieving symptoms or reducing haemodynamic burden when complete anatomical correction is not feasible.
Risk stratification: The process of categorising patients by likelihood of adverse events to tailor follow-up and treatment intensity.
References
- Complex Congenital Heart Disease in the Adult. Annual Review of Medicine (2024).
- Outcome of cardiac surgery in patients with congenital heart disease in England between 1997 and 2015. PLOS ONE (2017).
- Projected growth of the adult congenital heart disease population in the United States to 2050: an integrative systems modeling approach. Population Health Metrics (2015).
- Sacubitril/valsartan in the treatment of systemic right ventricular failure. Heart (2021).
- Person-centred transition programme to empower adolescents with congenital heart disease in the transition to adulthood: a study protocol for a hybrid randomised controlled trial (STEPSTONES project). BMJ Open (2017).
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