The impact of interventional cardiology for the management of adults with congenital heart defects.
The objective of this study is to assess the impact of interventional cardiology procedures for the management of ACHD. The interventional approach to the management of CHD in the adult population is becoming increasingly recognized as the preferred treatment option for a wide number of congenital cardiac conditions. The files of all consecutive patients over 18 years of age who were hospitalized in our department from January 2000 to December 2004 were reviewed. Over the study period, 1,115 ACHD (583 women; mean age 41 +/- 13.8, years, range 18-72 years) were hospitalized in our department; 752 patients underwent cardiac catheterization and 82.4% of them had an interventional procedure carried out. ASD (329/620) and PFO (159/620) closure account for 78% of all the procedures carried out, with a 2.7% of major complications incidence (all of them closing ASDs). Other procedures such as stenting aortic coarctation (40/620), ventricular septal defect closure (33/620), patent ductus arteriosus embolization (30/620), pulmonary valvuloplasty (12/620), stenting pulmonary artery branches (8/620), etc (5/620) were carried out. The most important complication was one death, which occurred in the case of a 22-year-old woman after stent implantation for a recurrent aortic coarctation. A trivial residual shunt was detected in only 5% of the patients who had a 6-month follow-up after VSD closure; no residual shunt was found after PDA embolization during the 12-month follow-up. In conclusion, we believe that the interventional approach is a safe and successful treatment option for a wide number of congenital cardiac conditions. The increasing use of catheter interventions for these patients will be responsible for an increase of complex cases in surgery.
Chessa
Massimo
M
Pediatric Cardiology and Adult with Congenital Heart Disease Department, Policlinico San Donato, Milan-Italy. massimo.chessa@grupposandonato.it
Carrozza
Marianna
M
Butera
Gianfranco
G
Negura
Diana
D
Piazza
Luciane
L
Giamberti
Alessandro
A
Feslova
Vasta
V
Bossone
Edoardo
E
Vigna
Carlo
C
Carminati
Mario
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D016009:Chi-Square Distribution; D004621:Embolization, Therapeutic; D006330:Heart Defects, Congenital / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D018709:Statistics, Nonparametric; D015607:Stents; D016896:Treatment Outcome