title: [Congenital cardiopathies in adults. 179 cases].
abstract: Congenital heart disease in the adult represents less than 25 p. 100 of all congenital heart diseases; 179 out of 800 cases in the authors' experience. Atrial septal defect (ASD) is by far the most common (44 cases) especially in adults over 40 years of age. Practically all large ASD develop complications and systematic repair is recommended in all age groups except in forms with severe pulmonary hypertension and high pulmonary arteriolar resistance. Ventricular septal defect (VSD) is almost as common. They are usually small and only rarely present after 40 years of age, suggesting that spontaneous closure may occur even after 20 years of age. Coarctation of the aorta should be operated on before adulthood as persistant hypertension becomes more common in patients operated later. Eisenmenger's syndrome, the inevitable conclusion of VSD with severe hypertension not operated during childhood, or of some large ASDs in adults is often well tolerated and may survive until an advanced age. Survival of Fallot's tetralogy is very rare after 20 years without surgery; complete repair should therefore be performed early despite its drawbacks. Thus, unoperated congenital heart diseases should no longer be observed in adults excepting minor forms which do not justify the operative risks, and complicated forms for which no surgical cure is yet available.
mesh_terms: D000328:Adult; D000367:Age Factors; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics; D006801:Humans
vernacular_title: Cardiopathies congénitales de l'adulte. Cent soixante-dix-neuf cas.