© 2014, Wiley Periodicals, Inc. DOI: 10.1111/echo.12337
Echocardiography
ECHO IN ADULT CONGENITAL HEART DISEASE
Echocardiography in Patients with Adult Congenital Heart Disease Ramdas G. Pai, M.D. Department of Cardiology, Loma Linda University Medical Center, Loma Linda, California
(Echocardiography 2014;00:1) Congenital heart disease affects about 1% of live births. The mortality in these patients has dramatically dropped since 1970s thanks to neonatal corrective surgery and improved surgical techniques. Currently, there are about 1 million adults with congenital heart disease in United States alone. This number is likely to increase to 2 million or 1 in 150 adults in 2025. In addition to increasing frequency, this patient population poses unique challenges in terms of complexity of pathology and corrective surgery, residual defects and sequela added on to potential acquired heart diseases. Evaluating and managing these patients will need special expertise not routinely acquired during cardiology fellowship training. The ACC/AHA 2008 guidelines on management of adult congenital heart disease (ACHD) recommend establishment of regional ACHD centers of excellence to serve as a resource for patients and providers, enhanced education of cardiovascular specialists in ACHD and enhanced access to care.1 Echocardiography plays a central role in the evaluation of any patients with ACHD. Cardiologists may be called to see these patients admitted in nonspecialized centers for noncardiac issues as well. Noncardiac issues may interact with cardiac issues. In addition to echocardiography, one needs to understand the abnormal
anatomy, physiology, surgical corrections, sequela, and their management. This special issue attempts to address these issues in some of the most commonly encountered ACHD in adult practice emphasizing the information an echocardiographer needs to obtain. We are grateful to the outstanding contributions from many experts with vast experience in this field. These contributions address the areas of atrial septal defect, patent ductus arteriosus, LV outflow obstructions, tetralogy of Fallot, transposition of great arteries, univentricular physiology and cavopulmonary shunts, and Ebstein’s anomaly. We hope these will help the providers to be able to deliver better care to patients with ACHD. Reference 1. Warnes CA, Williams RG, Bashore TM, et al: ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration with the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008;52:e143–e263.
Address for correspondence and reprint requests: Ramdas G. Pai, M.D., Professor of Medicine, Loma Linda University Medical Center, Loma Linda, CA 92354. E-mail: [email protected]
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Echocardiography
ECHO IN ADULT CONGENITAL HEART DISEASE
Echocardiography in Patients with Adult Congenital Heart Disease Ramdas G. Pai, M.D. Department of Cardiology, Loma Linda University Medical Center, Loma Linda, California
(Echocardiography 2014;00:1) Congenital heart disease affects about 1% of live births. The mortality in these patients has dramatically dropped since 1970s thanks to neonatal corrective surgery and improved surgical techniques. Currently, there are about 1 million adults with congenital heart disease in United States alone. This number is likely to increase to 2 million or 1 in 150 adults in 2025. In addition to increasing frequency, this patient population poses unique challenges in terms of complexity of pathology and corrective surgery, residual defects and sequela added on to potential acquired heart diseases. Evaluating and managing these patients will need special expertise not routinely acquired during cardiology fellowship training. The ACC/AHA 2008 guidelines on management of adult congenital heart disease (ACHD) recommend establishment of regional ACHD centers of excellence to serve as a resource for patients and providers, enhanced education of cardiovascular specialists in ACHD and enhanced access to care.1 Echocardiography plays a central role in the evaluation of any patients with ACHD. Cardiologists may be called to see these patients admitted in nonspecialized centers for noncardiac issues as well. Noncardiac issues may interact with cardiac issues. In addition to echocardiography, one needs to understand the abnormal
anatomy, physiology, surgical corrections, sequela, and their management. This special issue attempts to address these issues in some of the most commonly encountered ACHD in adult practice emphasizing the information an echocardiographer needs to obtain. We are grateful to the outstanding contributions from many experts with vast experience in this field. These contributions address the areas of atrial septal defect, patent ductus arteriosus, LV outflow obstructions, tetralogy of Fallot, transposition of great arteries, univentricular physiology and cavopulmonary shunts, and Ebstein’s anomaly. We hope these will help the providers to be able to deliver better care to patients with ACHD. Reference 1. Warnes CA, Williams RG, Bashore TM, et al: ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration with the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008;52:e143–e263.
Address for correspondence and reprint requests: Ramdas G. Pai, M.D., Professor of Medicine, Loma Linda University Medical Center, Loma Linda, CA 92354. E-mail: [email protected]
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