Abstract
Children with congenital heart disease (CHD) are at risk for increased morbidity from viral lower respiratory tract infections because of anatomical cardiac lesions than can worsen an already compromised respiratory status. Respiratory syncytial virus (RSV) remains an important pathogen in contributing toward the morbidity in this population. Although the acute treatment of RSV largely remains supportive, the development of monoclonal antibodies, such as palivuzumab, has reduced the RSV-related hospitalization rate in children with CHD. This review highlights the specific cardiac complications of RSV infection, the acute treatment of bronchiolitis in patients with CHD, and the search for new therapies against RSV, including an effective vaccine, because of the high cost associated with immunoprophylaxis and its lack of reducing RSV-related mortality.
Highlights
Surgical outcomes in children with congenital heart disease (CHD) have improved over the past two decades because of advances in prenatal diagnosis, surgical and cardiopulmonary bypass techniques, and postoperative management [1]
It is expected that adult patients with CHD exceed the number of children with CHD [2], and the majority of patients who have undergone surgical correction for their CHD do not consider their quality of life to be impacted by their malformation [3]
It is critical for both primary care physicians and pediatric cardiologists to remain familiar with the current epidemiology and clinical management of respiratory pathogens in children with CHD, while understanding what contemporary prophylactic options exist in minimizing the burden of viral respiratory infections throughout this population
Summary
Surgical outcomes in children with congenital heart disease (CHD) have improved over the past two decades because of advances in prenatal diagnosis, surgical and cardiopulmonary bypass techniques, and postoperative management [1]. It is expected that adult patients with CHD exceed the number of children with CHD [2], and the majority of patients who have undergone surgical correction for their CHD do not consider their quality of life to be impacted by their malformation [3] These improved outcomes require a significant economic investment so that processes of care are optimally aligned throughout the continuum of a patient’s life from initial diagnosis, through his or her surgical correction (including postoperative management) and after hospitalization followup. Respiratory infections are significantly more likely to be the cause of death during the winter than the summer [4] It is critical for both primary care physicians and pediatric cardiologists to remain familiar with the current epidemiology and clinical management of respiratory pathogens in children with CHD, while understanding what contemporary prophylactic options exist in minimizing the burden of viral respiratory infections throughout this population. 10% of these episodes will lead to hospitalization, and it is estimated that 66,000–199,000 children will die from RSV-associated LRTI; 99% of whom will be from developing countries [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
