title: Adult congenital heart disease investigated with cardiac catheterization over a 20-year period.
abstract: BACKGROUND
  Recent advances in diagnosis and treatment have increased the life expectancy of patients with congenital heart disease.
  
  
  METHODS
  To investigate the prevalence of adult congenital heart disease (ACHD) in a large registry of patients over a 20-year period, we retrospectively assessed data of 14,012 males and 4,461 females who underwent clinically indicated cardiac catheterization from 1984 to 2003.
  
  
  RESULTS
  ACHD was recorded in 234 subjects aged from 18 to 66 years, [95 males (40.7%) and 139 females (59.3%)]. Females were more likely to present with ACHD than males (p<0.001). Atrial septal defect was the most common defect (43.3%) followed by partial anomalous pulmonary venous return (12.0%), pulmonary valve stenosis (11.3%) ventricular septal defect (8.0%), coarctation of aorta (5.5%) patent ductus arteriosus (4.0%) and Fallot's tetralogy (3.3%). Atrial septal defect was more common in females (p<0.01), while pulmonary valve stenosis was more frequent in males (p<0.05). No difference across sexes was found in the other forms of ACHD. Females with ACHD were significantly older than males at the time of catheterization (median age 41 years, interquartile range 26 to 53 years vs. median age 35 years, interquartile range 22 to 48 years, p<0.05).
  
  
  CONCLUSIONS
  In adulthood ACHD is found more commonly in females and is diagnosed later in life than in males. Atrial septal defect is the most prevalent form of ACHD and occurs most commonly in females.
authors.affiliation: 1st Cardiology Department, AHEPA University Hospital, Aristotle University Medical School, 1 St. Kyriakidi Street, 54636, Thessaloniki, Greece. yan@med.auth.gr
authors.forename: George D
authors.initials: GD
authors.lastname: Giannoglou
authors.forename: Antonios P
authors.initials: AP
authors.lastname: Antoniadis
authors.forename: Yiannis S
authors.initials: YS
authors.lastname: Chatzizisis
authors.forename: George E
authors.initials: GE
authors.lastname: Louridas