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改善成人先天性心脏病患者的医疗护理与预防——对一个全球性问题的思考——第二部分:感染性心内膜炎、肺动脉高压、动脉性肺动脉高压和主动脉病变

Improving medical care and prevention in adults with congenital heart disease-reflections on a global problem-part II: infective endocarditis, pulmonary hypertension, pulmonary arterial hypertension and aortopathy.

作者信息

Neidenbach Rhoia, Niwa Koichiro, Oto Oeztekin, Oechslin Erwin, Aboulhosn Jamil, Celermajer David, Schelling Joerg, Pieper Lars, Sanftenberg Linda, Oberhoffer Renate, de Haan Fokko, Weyand Michael, Achenbach Stephan, Schlensak Christian, Lossnitzer Dirk, Nagdyman Nicole, von Kodolitsch Yskert, Kallfelz Hans-Carlo, Pittrow David, Bauer Ulrike M M, Ewert Peter, Meinertz Thomas, Kaemmerer Harald

机构信息

Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany.

Department of Cardiology, Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan.

出版信息

Cardiovasc Diagn Ther. 2018 Dec;8(6):716-724. doi: 10.21037/cdt.2018.10.16.

Abstract

Despite relevant residua and sequels, follow-up care of adults with congenital heart disease (ACHD) is too often not performed by/in specialized and/or certified physicians or centers although major problems in the long-term course may develop. The most relevant encompass heart failure, cardiac arrhythmias, heart valve disorders, pulmonary vascular disease, infective endocarditis (IE), aortopathy and non-cardiac comorbidities. The present publication emphasizes current data on IE, pulmonary and pulmonary arterial hypertension and aortopathy in ACHD and underlines the deep need of an experienced follow-up care by specialized and/or certified physicians or centers, as treatment regimens from acquired heart disease can not be necessarily transmitted to CHD. Moreover, the need of primary and secondary medical prevention becomes increasingly important in order to reduce the burden of disease as well as the socioeconomic burden and costs in this particular patient group.

摘要

尽管存在相关的残留问题和后遗症,但先天性心脏病成人患者(ACHD)的随访护理往往并非由专科医生或有资质的医生进行,也不是在专科或有资质的中心开展,尽管长期病程中可能会出现重大问题。最相关的问题包括心力衰竭、心律失常、心脏瓣膜疾病、肺血管疾病、感染性心内膜炎(IE)、主动脉病变和非心脏合并症。本出版物强调了ACHD中关于IE、肺和肺动脉高压以及主动脉病变的当前数据,并强调了由专科医生或有资质的医生或中心提供经验丰富的随访护理的迫切需求,因为后天性心脏病的治疗方案不一定适用于先天性心脏病。此外,为了减轻这一特定患者群体的疾病负担以及社会经济负担和成本,一级和二级医疗预防的需求变得越来越重要。

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