title: Heart Failure in Adult Congenital Heart Disease: Nonpharmacologic Treatment Strategies.
abstract: In early stages, heart failure (HF) in adult congenital heart disease (ACHD) remains an elusive diagnosis. Many ACHD patients seem well-compensated owing to chronic physical and psychological adaptations. HF biomarkers and cardiopulmonary exercise tests are often markedly abnormal, although patients report stable health and good quality of life. Treatment differs from acquired HF. Evidence for effective drug therapy in ACHD-related HF is lacking. Residual ventricular, valvular, and vascular abnormalities contribute to HF pathophysiology, leading to an emphasis on nonpharmacologic treatment strategies. This article reviews emerging perspectives on nonpharmacologic treatment strategies, including catheter-based interventions, surgical correction, and palliative care.
authors.affiliation: Adult Congenital Heart Disease Program, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97239, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: LeMond
authors.affiliation: Adult Congenital Heart Disease Program, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97239, USA.
authors.forename: Tuan
authors.initials: T
authors.lastname: Mai
authors.affiliation: Adult Congenital Heart Disease Program, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97239, USA.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Broberg
authors.affiliation: Pediatric Cardiac Surgery, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR 97239, USA.
authors.forename: Ashok
authors.initials: A
authors.lastname: Muralidaran
authors.affiliation: Adult Congenital Heart Disease Program, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97239, USA. Electronic address: burchilu@ohsu.edu.
authors.forename: Luke J
authors.initials: LJ
authors.lastname: Burchill
mesh_terms: D000328:Adult; D006330:Heart Defects, Congenital / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D006333:Heart Failure / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans
keywords: Adult congenital heart disease; Arrhythmia; Biomarkers; Cardiac surgery; Heart failure; Structural intervention