Adult Congenital Heart Diseases: Clinical Pattern, Management and Immediate Outcome in Ibn-Al-Bitar Center for Cardiac Surgery, Baghdad 2013

Authors

  • Hassan Al-Farhan Assistant Prof. Consultant Cardiologist FICMS (Cardio), DIC, FACC, DMe
  • Jasim Nasir Alkhalidi M.B.Ch.B. C.A.B.P (Pediatric)

Keywords:

Adult, congenital, heart disease, Iraq

Abstract

Introduction: Adult with congenital heart diseases (ACHD) are an important emerging group. The diagnosis and successful management of congenital heart disease represents one of the greatest triumphs of cardiovascular medicine and surgery in the 20th century. As a consequence, the number of adults with congenital heart disease both with repaired and unrepaired lesions has grown rapidly. Patients and Methods: This is a descriptive cross sectional study that conducted in Ibn Al-Bitar Center for Cardiac Surgery during the period from January 2011to December 2012 Baghdad- Iraq. In this study all adults’ patients with CHD referred to Ibn Al-Bitar Center for Cardiac Surgery were recorded and evaluated to verify the pattern of ACHD in our center. Results: A total of 789 patients, female to male ratio was 1.7:1, Acyanotic CHD constitute 92.9%, and whereas the cyanotic lesions form only 7.1% .The mean age of patients was 29±7.300 SD years. The most common defect was ASD followed in order of frequency by VSD, PS, TOF, PDA, AS and COA. Trans catheter intervention was the treatments of choice for many types of ACHD, but still surgery play an important role in managements of other defects. Conclusions: Acyanotic ACHD are more common than the cyanotic one, more female predominance, Percutaneous intervention was became widely used as the first line of management of majority of ACHD with high successful rates, while surgical correction  still the treatment of choice for certain types of    ACHD .

References

- Hoffman JIE, Kaplan S. The incidence of congenital heart disease. Journal of the American College of Cardiology. 2002;39(12):1890-900.

- Catherine L. Webb, Kathy J. Jenkins, Peter P. Karpawich, et al, Collaborative Care for Adults With Congenital Heart Disease Barst and the Congenital Cardiac Defects Committee of the American Heart Association Section on Cardiovascular Disease in the Young. Circulation.2002; 105: 2318-2323doi: 10.1161/01.CIR.0000017557 .24261.A7.

- Peter Engelfriet, Eric Boersma, Erwin Oechslin, et al,The spectrum of adult congenital heart disease in Europe: morbidity and mortality in a five year follow-up period. The Euro Heart Survey on adult congenital heart disease. Eur Heart J. 2005 Nov; 26(21):2325-33. Epub 2005 Jul 4

- Michael A, Gatzoulis, Swan Lorna et al,Adult Congenital HeartDisease,A practical guide, Department of Cardiology Western In remarry Glasgow, UK Judith Therrien Sir M. Davis Jewish General HospitalMcGill University Montreal, Quebec, Canada George A. Pantely.2005.

- Douglas Moodie, D, M, Joseph S. Coselli, MD,Adult congenital heart diseases, Past, Present, and Future. Texas Heart Institute J. 2011; 38(6): 705–706. Bethesda MD, 20894 USA

- Allen, Hugh D. Driscoll, David J. Shaddy et al, Moss and Adams' Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adults. Lippincott Williams & Wilkins, 2008 - Medical - 1680 pages Established since 1968 as a classic pediatric cardiology text

- Carole A. Warnes, MD, MRCP, FACC Rochester, Minnesota The Adult with Congenital Heart Disease Born to Be Bad? Journal of the Americam Collage of Cardiology JACC, Copyright © 2005 American College of Cardiology Foundation. Published by Elsevier Inc. Copyright © 2013 Elsevier B.V. July 2005, Pages 1–8.

- J Am Coll,American College of Cardiology. Care of the adult with congenital heart disease. Presented at the 32nd Bethesda Conference, Bethesda, Maryland, 2–3 October 2000 Cardiol 2001;37:1161–1198.

- Gary D. Webb MD, Piers E. F. Daubeney MA MRCP MRCPCH.Diagnosis and Management of Adult Congenital Heart Disease.pages528 Copyright 2011. Copyright © 2013.

- Richard Liberthson, Carole A. Warnes, MD, FACC, Co-Chair, et al,The Changing Profile of Congenital Heart Disease in Adult Life. 2001 Apr;37(5):1170-5. J Am Coll Cardiol. 2001.

- Yusuf Karamermer and Jolien W Roos-Hesselink,Pregnancy and adult congenital heart disease. Future Cardiol. 2007;3(5):559-567. 2007 Future Medicine Ltd. Posted 10/29/2007

- Professor Philip J. Steer. Pregnancy and Contraception Adult Congenital Heart Disease, A practical guide, Department of Cardio logy Western In remarry Glasgow, UK Judith Therrien Sir M. Davis Jewish General Hospital McGill University Montreal, Quebec, Canada George A. Pantely.2005.Academic Department of Obstetrics and Gynaecology, Chelsea andWestminster Hospital & Faculty of Medicine, Imperial College, London, UK. BMJ. 2006 February 18; 332(7538): 401–406.doi: 10.1136/bmj.332.7538.401

- Presbitero. J Somerville, E Aruta. D, Spiegelhalter, et al,Pregnancy in cyanotic congenital heart disease. Outcome of mother and fetus.Grown-Up Congenital Heart Unit, Royal Brompton National Heart and Lung Hospital, London, UK. June 2007, Pages 2303–2311.

- Therrien J, Gatzoulis M, Graham T, et al Consensus Conference 2001update: Recommendations for the management of adults with congenital heart disease. Part II. Can JCardiol 2001.

- Landzberg MJ, Murphy DJ Jr, Davidson WR Jr, et al. Task force4: organization of delivery systems for adults with congenital heart disease. J Am Coll Cardiol 2001;37(5):1187–9.

- Harris L, Balaji S. adult with congenital heart disease. In :Gatzoulis MA, Webb GD, Daubeney PEF, eds. Diagnosis and Management of Adult Congenital Heart Disease. London: Churchill Livingstone, 2003.

- Li W, Somerville J. Infective endocarditis in the grown-up congenital heart (GUCH) population. Eur. Heart J 1998; 19:166-173.

- Therrien J, Dore A, Gersony W, Iserin L, et al CCS Consensus Conference 2001 update: recommendations for the management of adults with congenital heart disease. Part I. Can J Cardiol 2001.

- Philip Moons, Kristien Van Deyk, Kristel Marquet,et al,Individual quality of life in adults with congenital heart disease: a paradigm shift. European Heart Journal (impact factor: 10.48). 03/2005; 26(3):298-307. DOI:10.1093/eurheartj/ehi054.

- Douglas Moodie , Nature Clinical Practice Cardio vascular Medicine New challenges and opportunities in adult congenital heart disease.(2005) 2, 373doi:10.1038/cardio0275

- L Shamima Sharmin, M Azizul Haque, M Iqbal Bari, Pattern and Clinical Profile of Adult Congenital Heart Disease in A Teaching Hospital prospective study conducted in the Rajshahi Medical College. Published in 2008.TAJ:Journal of teachers association. Vol 21, No 1 (2008)

- Abbag F,Pattern of CHD in Saudi Arabia, (Dept. of Child Health,Coll. of Medicine, King Saud Univ, Abha (Saudi Arabia). Ann Saudi Med 1998;18(5):393-395.

- Zhao QM, Ma XJ, Jia B, Huang GY et al,Prevalence of congenital heart disease at live birth:an accurate assessment by echocardiographic screening.Hospital of Fudan University, Shanghai, China. 2013 Jan 25. doi: 10.1111/apa.12170. [Epub ahead of print]. 2013 The Author(s)/Acta Paediatrica ©2013 Foundation Acta Paediatrica.

- Rahman F, Salman M, Akhter N, Patwary SRet al,Pattern of congenital heart diseases in adult. 2012 Apr;21(2):246-50. PMID:22561766 PubMed - indexed for MEDLINE]

- A.C. Zomer, MD; C.L. Verheugt, MD, PhD; I. Vaartjes, PhD C.S.P.M. Uiterwaal, et al,Congenital Heart Disease Surgery in Adults With Congenital Heart Disease. 2011 Nov 15;124(20):2195-201. doi: 10.1161/CIRCULATIONAHA.111.027763. Epub 2011 Oct 10.

- S Hechter, S C Siu, G D Webb,et al, Outpatient clinics for adults with congenital heart disease: increasing workload and evolving patterns of referral. Heart. 1999 January; 81(1): 57–61. 8600 Rockville Pike, Bethesda MD, 20894 USA.

- Gary Webb, MD; P. Engelfriet1 and B.J.M. Mulder et al. Congenital Heart Disease for the Adult Cardiologist, Atrial Septal Defects in the Adult Recent Progress and Overview. Circulation.2006; 114: 1645-1653doi: 10.1161/CIRCULATIONAHA.105.592055.

- Abe T, Kamata K, Taguchi A, Sugimoto S, Kawashima T, Inoue S, et al,Surgical treatment and long-term results of congenital heart disease in adults: early and late follow-up studies in 231 cases. Author: Larry W Markham, MD; Chief Editor: Park W Willis IV, MD. 1994 Jun;14(3):224-34. 8600 Rockville Pike, Bethesda MD, 20894 USA.

- Behjati M, Rafiei M, Soltani MH et al, Transcatheter closure of atrial septal defect with amplatzer septal occluder in adults: immediate, short, and intermediate-term results. Afshar Hospital,Shahid Sadoughi University of Medical Sciences, Yazd, Iran.The Journal of Tehran Heart Center 2011. J Tehran Heart Cent. 2011 Spring; 6(2): 79–84.Published online 2011 May 31.

- Suchon Elzbieta, Pieculewicz Monika, Tracz Wieslawa,et al, Transcatheter closure as an alternative and equivalent method to the surgical treatment of atrial septal defect in adults: Comparison of early and late result. Med Sci Monit. 2009; 15(12):CR612-7 . ISSN: 1643-3750)

- Lucian A. Durham, M.D., Ph. D. Director, Pediatric Cardiovascular Surgery Alan M. Mendelsohn, M. D. Director, Atrial Septal Defects: Surgical and Transcatheter Management, Pediatric Interventional Cardiology Strong Children's Heart Center University of Rochester Medical Center. Edited by: Mona Barmash Animation: KuoScientific GraphicsGraphic: Reprinted with permission from the Pediatric Cardiac Catheterization Laboratory, University of California, San Francisco Posted: December 17, 1998Updated: May, 2003

- Naser M Ammash, MDHeidi M Connolly, MDSection EditorCandice Silversides, et al Ventricular septal defect in adults. Literature review current through: Jun 2013. | This topic last updated: Oct 26, 2012.

- Karamarie Fecho,Anne T Lunney,Philip G Boysen, et al,Postoperative mortality after in patient surgery: Incidence and risk factors. Ther Clin Risk Manag. 2008 August; 4(4):681–688.Published online 2008August.

- Alan D. Tong, M.D, FACC Pediatric Cardiologist Cedars- Sinai Medical Center Los Angeles, CA, Pulmonic Stenosis and Balloon Valvuloplasty.Posted: May9,1997 Updated: May3,2001 Edited by: Mona Barmah.

- Teupe C, Burger W, Schrader R, et al, Balloon dilatation of valvular pulmonary stenosis in adults . in PubMed 1997 Dec;86(12):1026-32.

- Lip G, Y. H. Singh S, P. DE Giovanni Jet al,Percutaneous balloon valvuloplasty for congenital Pulmonary valve stenosis in adults. in PubMed 1996 Jul 4;335(1):21-5. N Engl J Med.

- Eduardo E. Chang, MD, Lisa Diethelm, MD, Joseph A. Lasky, et al, Persistent Patent Ductus Arteriosus in an Adult Section of Pulmonary Disease, Critical Care and Environmental Medicine, Tulane University. South Med J. 2001;94(3) . medscape, Lippincott Williams & Wilkins ..

- Early and late results of total correction of tetralogy of Fallot. Department of Cardiovascular Surgery, Cardiovascular Research Center, Shahid Madani Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. Acta Med Iran. 2010 Mar-Apr;48(2):117-22.

- Erdoan HB, Bozbua N, Kayalar N, Erentu V, Omerolu SN,et al, Long-term outcome after total correction of Tetralogy of Fallot in adolescent and adult age. J Card Surg. 2005 Mar-Apr;20(2):119-23 Bethesda MD, 20894 USA

- Abdul Razzaq Naser Hussein, Total correction of TOF at the medical city teaching hospital, A thesis submitted to the scientific council of thoracic and cardiovascular surgery in partial fulfillments of the requirement for the fellowship of the Iraqi commission for medical specialization, supervisor Dr. Emad AL Mashat, 1994.

- Ali Akbar Zeinaloo, MD, Seyyed Mahmoud Meraji, MD2 Keyhan Sayadpour Zanjani,et al, Device Occlusion versus Surgery for Closure of Congenital Heart Defects: Cost Issues in Iran. Received 14 February 2008; Accepted 10 April 2008.

- Brad C. Astor, Ronald G, Kaczmarek, MD, et al,Mortality after aortic valve replacement: results from a nationally representative database. Ann Thorac Surg. 2000 Dec;70(6):1939-45.

- Lieberman EB, Wilson JS, Harrison JK, et al, Aortic valve replacement in adults after balloon aortic valvuloplasty,Davidson CJ. Division ofCardiology, Duke University MedicalCenter,Durham,NC. Circulation (1994)Volume: 90, Issue: 5 Pt 2, Pages: II205-I208PubMed: 7955254

- Guerin F, Richaud M, Duboc D, et al Congenital valvular aortic stenosis in adults.France.European Heart Journal. Oxford JournalsMedicineEuropean Heart JournalCardio image bankValvular Medicine Cardiology Update 2013

- McAnulty JH,Timing of surgical therapy for aortic valve stenosis. Goals of therapy. Volume 43, Issue 6, May–June 2001, Pages 477–493Timing of Valvular Surgery

- C Zabal, F Attie, A Buendía-Hernández, et al,The adult patient with native coarctation of the aorta:balloon angioplasty or primary stenting? Heart. 2003 January; 89(1): 77–83. Journal List Heartv.89(1); Jan 2003 PMC1767490.

- Balloon angioplasty with or without stenting for coarctation or recoarctation of aorta in adults and children. Interventional procedures IPG74. This page was last updated: 15 May 2012Issued: July 2004 Copyright 2013 National Institute for Health and Care Excellence The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on balloon angioplasty with or without stenting for coarctation or recoarctation of the aorta in adults and children.

- Thomas J. Forbes, MD, Dennis W. Kim, MD, PHD. Comparison of Surgical, Stent,and Balloon Angioplasty,Treatment ofNative Coarctation of the AortaAn Observational Study by the CCISC(Congenital Cardiovascular Interventional Study Consortium). 2011 Dec 13;58(25):2664-74. doi: 10.1016/j.jacc.2011.08.053. J Am Coll Cardiol.

- Mohamed A Hamdan, MBBS, Sunita Maheshwari, MD, John T Fahey, MD, FACC, William E Hellenbrand, MD, FACC. Endovascular stents for coarctation of the aorta: initial results and intermediate-term follow-up. 2001 Nov 1;38(5):1518-23. J Am Coll Cardiol. PubMed. Bethesda MD, 20894 USA.

- Mohammed Mahmod Saleem,Coaractation of aorta, A thesis submitted to the scientific council of thoracic and cardiovascular surgery in partial fulfillments of the requirement for the fellowship of the Iraqi commission for medical specialization, supervisor Dr. Siddiq AL Khashab,1998.

Downloads

Published

2020-09-05

Issue

Section

Articles