Geriatric congenital heart disease: a new challenge in the care of adults with congenital heart disease?

Abstract

This editorial refers to ‘Congenital heart disease beyond the age of 60: emergence of a new population with high resource utilization, high morbidity, and high mortality’[†][1], by O. Turatel et al. , on page 725 and ‘Recommendations for organization of care for adults with congenital heart disease and for training in the subspecialty of ‘Grown-up Congenital Heart Disease’ in Europe: a position paper of the Working Group on Grown-up Congenital Heart Disease of the European Society of Cardiology’[‡][2], by H. Baumgartner et al ., on page 686 The major advances in paediatric heart surgery and paediatric cardiology over recent decades resulted in a markedly increasing number of patients with congenital heart disease who survive into adulthood.1,2 While 90% of patients with complex disease died during childhood when born in the 1950s, the majority already survived beyond 18 years when born in the 1980s.3,4 Thus, we are faced now with a new population of grown-ups with congenital heart disease (CHD) who need very special care.1,2 Although the number of adults with CHD currently living in the European Union must be estimated at around 1 million patients, they nevertheless represent only a minority within the population of adults with cardiovascular disease4 considering that ∼24 million may, for example, suffer from coronary artery disease as one of the major players.5 Thus, CHD is rarely seen in the non-specialized clinical practice of cardiology. In addition, the diversity of CHD and the resulting clinical problems are immense.1 Although knowledge of adult CHD (ACHD) has grown in recent years, the spectrum of disease and late complications are constantly changing due to the development of improved surgical techniques over the years. A typical example is transposition of the great arteries. In the current population of adults, … [1]: #fn-2 [2]: #fn-3