Abstract

YANEZ-GUTIERREZ, Lucelli et al. The adult with congenital heart disease. Rev. Mex. Cardiol [online]. 2015, vol.26, n.4, pp.158-162. ISSN 0188-2198.

Background: The study show the most important demographic and clinical data of a cohort composed by adults treated in a congenital heart clinic. Material and methods: In a retrospective, observational and longitudinal study, data from patients with congenital heart disease, older than 18 years, seen between May 2010 and May 2013, were analyzed. Results: The cohort comprised 409 patients, 280 of them female (69%), whose mean age at the time of the first evaluation was 36.7 ± 14.2 years (range, 18 to 75 years). Thirty-four of them (8%) had cyanotic congenital heart disease (14 cases of tetralogy of Fallot, the rest with a univentricular heart and Eisenmenger). The mean age when heart disease was diagnosed was 33.6 ± 15.9 years (range, from birth to 75 years). One hundred five patients (38%) were aware of having heart disease but did not have regular follow-up. The reason for referral was heart murmur in 143 subjects (35%); in 143 (35%) for deterioration of functional class due to progressive dyspnea; supraventricular arrhythmias in 24 (6%); chest pain in 16 (4%), in 12 arterial hypertension (3%) and in 8 (2%) history of cerebral vascular event. On regard of the types of congenital heart disease, 71% were intracardiac defects (mainly interatrial and interventricular septal defects), 10% left and right obstructive lesions, as well as aortic coarctation, 7% mixed valve lesions, 2% cardiomyopathy, and the rest with diseases like anomalous origin of the left coronary artery, double discordance and univentricular heart. In 188 patients (46%) surgical treatment was opted, meanwhile in other 138 (34%) interventional percutaneous treatments were chosen, and in 83 (20%) medical treatment was selected. Fifteen patients suffered complications related to treatment, 50% of them infections, arrhythmias or heart failure. Mortality occurred in six cases, all from the surgical group. The cause of death was refractory heart failure and cardiogenic shock in the postoperative phase. Pulmonary pressure descended from 48.3 ± 20.4 mmHg before the therapeutic procedure to 36.3 ± 16.2 mmHg after it (p < 0.001). Conclusions: Adults with congenital heart disease form a complex study group that in addition to the underlying disease, have a combination of other diseases and/or cardiovascular risk factors as well as several complications related to previous therapeutic procedures.

Keywords : Congenital heart disease; adults; complications of treatment; follow-up of congenital heart diseases.

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