Jennifer F Gerardin1,2, Michael G Earing3,4,5. 1. Division of Pediatric Cardiology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA. jgerardin@chw.org. 2. Children's Hospital of Wisconsin, 8915 W. Connell Ct., P.O. Box 1997, Milwaukee, WI, 53226, USA. jgerardin@chw.org. 3. Division of Pediatric Cardiology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA. 4. Children's Hospital of Wisconsin, 8915 W. Connell Ct., P.O. Box 1997, Milwaukee, WI, 53226, USA. 5. Division of Cardiovascular Medicine, Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Abstract
PURPOSE OF REVIEW: Highlight the extracardiac comorbidities that adult congenital heart disease patients and summarize the current recommendations for non-cardiac surgery. RECENT FINDINGS: Adult congenital heart disease patients are living longer, becoming more complex and developing adult comorbidities as they age. These patients have multiorgan involvement including higher prevalence of kidney disease and decreased lung function. Non-cardiac comorbidities can complicate surgery in this patient population. Most patients have non-cardiac surgery in community settings. These settings may increase adverse events during and in the post-operative period. Survival is improved when moderate and complex patients are seen in regional referral centers. Improved awareness of long-term complications of congenital heart disease and extracardiac comorbidities for adult congenital heart disease patients is needed. Appropriate care settings with both congenital heart disease expertise and adult subspecialty care reduces morbidity and mortality in these complex patients.
PURPOSE OF REVIEW: Highlight the extracardiac comorbidities that adult congenital heart diseasepatients and summarize the current recommendations for non-cardiac surgery. RECENT FINDINGS: Adult congenital heart diseasepatients are living longer, becoming more complex and developing adult comorbidities as they age. These patients have multiorgan involvement including higher prevalence of kidney disease and decreased lung function. Non-cardiac comorbidities can complicate surgery in this patient population. Most patients have non-cardiac surgery in community settings. These settings may increase adverse events during and in the post-operative period. Survival is improved when moderate and complex patients are seen in regional referral centers. Improved awareness of long-term complications of congenital heart disease and extracardiac comorbidities for adult congenital heart diseasepatients is needed. Appropriate care settings with both congenital heart disease expertise and adult subspecialty care reduces morbidity and mortality in these complex patients.
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Authors: Steven H Abman; Georg Hansmann; Stephen L Archer; D Dunbar Ivy; Ian Adatia; Wendy K Chung; Brian D Hanna; Erika B Rosenzweig; J Usha Raj; David Cornfield; Kurt R Stenmark; Robin Steinhorn; Bernard Thébaud; Jeffrey R Fineman; Titus Kuehne; Jeffrey A Feinstein; Mark K Friedberg; Michael Earing; Robyn J Barst; Roberta L Keller; John P Kinsella; Mary Mullen; Robin Deterding; Thomas Kulik; George Mallory; Tilman Humpl; David L Wessel Journal: Circulation Date: 2015-11-03 Impact factor: 29.690