Bouma B J, Sieswerda G T, Post M C, Ebels T, van Kimmenade R, de Winter R J, Mulder B J
Department of Cardiology, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.
Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Neth Heart J. 2020 Aug;28(Suppl 1):44-49. doi: 10.1007/s12471-020-01455-5.
Congenital heart disease (CHD) affects 0.8% of live births and over the past decades technical improvements and large-scale repair has led to increased survival into adulthood of over 95% of the new-born. A new group of patients, those who survived their congenital heart defect, has emerged but late complications including heart failure, pulmonary hypertension (PH), arrhythmias, aneurysms and endocarditis appeared numerous, with a huge impact on mortality and morbidity. However, innovations over the past years have changed the landscape of adult CHD dramatically. In the diagnostic process important improvements have been made in the use of MRI, biomarkers, e‑health concepts and 3D visualisation of anatomy. Care is now concentrated in specialised centres, with a continuous emphasis on education and the introduction of weekly multidisciplinary consultations on diagnosis and intervention. Surgery and percutaneous intervention have been refined and new concepts applied, further reducing the burden of the congenital malformations. Research has matured from case series to global networks. Currently, adults with CHD are still facing high risks of early mortality and morbidity. By global collaboration and continuous education and development and innovation of our diagnostic and therapeutic arsenal, we will improve the perspectives of these young patients.
先天性心脏病(CHD)影响0.8%的活产婴儿。在过去几十年里,技术进步和大规模修复使超过95%的新生儿存活至成年。一类新的患者群体——那些先天性心脏缺陷存活者出现了,但包括心力衰竭、肺动脉高压(PH)、心律失常、动脉瘤和心内膜炎在内的晚期并发症众多,对死亡率和发病率产生了巨大影响。然而,过去几年的创新极大地改变了成人先天性心脏病的局面。在诊断过程中,MRI、生物标志物、电子健康概念和解剖结构的3D可视化应用取得了重要进展。现在,医疗护理集中在专门的中心,不断强调教育,并引入每周一次的多学科诊断和干预会诊。手术和经皮介入技术得到了改进,并应用了新的概念,进一步减轻了先天性畸形的负担。研究已从病例系列发展到全球网络。目前,患有先天性心脏病的成年人仍然面临早期死亡和发病的高风险。通过全球合作以及持续的教育,以及我们诊断和治疗手段的不断发展与创新,我们将改善这些年轻患者的前景。