Nav: Home

Heart transplantation for adult CHD: Overview and special considerations

June 10, 2018

In the current issue of Cardiovascular Innovations and Applications (Volume3, Number 1, 2018, pp. pp. 73-84(12); DOI: 10.15212/CVIA.2017.0043, Dipankar Gupta, Jana Reid, Diego Moguillansky, Renata Shih, Mark S. Bleiweis, Frederick J. Fricker and Biagio A. Pietra from the Congenital Heart Center, Department of Pediatrics, UF Health Shands Children's Hospital, University of Florida, Gainesville, FL, USA consider how with improvements in surgical and medical management, the number of patients with congenital heart disease (CHD) reaching adulthood has increased over the last decade.

Success in the management of congenital heart disease (CHD) in the young is leading to an increasing number of heart transplants in adults with CHD. CHD has an incidence of 0.8-1%, translating to approximately 40,000 newborns per year. With improving surgical and interventional techniques and medical management, approximately 90% of children with CHD survive to adulthood. On the basis of a recent study, there are approximately 2.4 million people in the United States with CHD. On the basis of this study, the estimated number of adults with CHD in the United States is approximately 1.4 million. The population of adults with CHD in 2010 demonstrated a 63% increase when compared with the estimates from 2000, making it the fastest growing population in congenital cardiology. In addition, approximately 300,000 patients of the 1.4 million adults with CHD have evidence of severe CHDs. Adult CHD (ACHD) is associated with multiple morbidities secondary to the original anatomic substrate, multiple palliative procedures, and associated complications. Unfortunately, despite improved surgical and medical management, approximately 10-20% patients with CHD progress to end-stage heart failure as adults, and it is the most common cause of late death in patients with ACHD.

The cohort of ACHD patients is increasing significantly. There is a high likelihood for the need for heart transplantation as these patients develop chronic heart failure and other chronic sequelae of palliated CHD. It is important to recognize advanced heart failure and other associated complications early in this cohort of complex patients for early referral to an ACHD specialist. Because of the presence of multiple factors that can affect the long-term outcomes, there needs to be a careful selection process for transplantation to optimize the utilization of donor organs. Our experience with transplantation in ACHD patients demonstrates excellent short-term outcomes; however, the timing of transplantation is a huge challenge, mostly related to other end-organ dysfunction. Further studies are needed to continue to improve the outcomes after transplantation.
-end-
CVIA is available on the IngentaConnect platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information)

Cardiovascular Innovations and Applications

Related Congenital Heart Disease Articles:

Genes responsible for severe congenital heart disease identified by Pitt researcher
Genes responsible for hypoplastic left heart syndrome identified using mouse models.
Ablation for atrial fibrillation proven safe and effective for patients with congenital heart disease, Penn study finds
In a new study presented today at the Heart Rhythm Society's 38th Annual Scientific Session in Chicago, researchers from the Perelman School of Medicine at the University of Pennsylvania have found that CHD patients -- even with complex defects -- can safely undergo ablation for AF, with similar success rates as patients with normal hearts.
Lessening radiation risk for children with congenital and acquired heart disease
Newly released recommendations for pediatric radiation safety will be discussed during the Society for Cardiovascular Angiography and Interventions (SCAI) 2017 Scientific Sessions in New Orleans.
High-throughput, in vivo validation of candidate congenital heart disease genes
Specific genetic errors that trigger congenital heart disease in humans can be reproduced reliably in Drosophila melanogaster -- the common fruit fly -- an initial step toward personalized therapies for patients in the future.
Women with high-risk congenital heart disease can have successful pregnancies
Women with high-risk congenital heart disease can have successful pregnancies but should seek counseling before conception to understand how their conditions could affect pregnancy and their child's health.
First US babies treated in study of adult stem cell therapy for congenital heart disease
In a first-in-children randomized clinical study, medical researchers at the University of Maryland School of Medicine (UM SOM) and the Interdisciplinary Stem Cell Institute (ISCI) at the University of Miami Miller School of Medicine have begun testing to see whether adult stem cells derived from bone marrow benefit children with the congenital heart defect hypoplastic left heart syndrome (HLHS).
Children dying preventable deaths from congenital heart disease
Over one million children are born with congenital heart disease (CHD) each year, and 90 percent are born in poor regions with little or no access to care.
Einstein scientist receives $7.5 million grant for congenital heart disease research
The National Institutes of Health has awarded Bernice Morrow, Ph.D., at Albert Einstein College of Medicine and collaborators at the Children's Hospital of Philadelphia a five-year, $7.5 million grant to study the genetics of congenital heart abnormalities.
Mother's blood sugar measurement associated with baby's congenital heart disease risk
For the first time, researchers have shown that the level of blood sugar measured in the first trimester of pregnancy may be associated with the risk of delivering a baby with congenital heart disease, according to a preliminary study presented at the American Heart Association's Scientific Sessions 2016.
Women with congenital heart disease have better shot at healthy pregnancies
New research from the Perelman School of Medicine at the University of Pennsylvania reveals that women with CHD who are deemed high risk by conventional measures are more likely to have safe, healthy pregnancies than current risk-assessments suggest.

Related Congenital Heart Disease Reading:

Illustrated Field Guide to Congenital Heart Disease and Repair - Pocket Sized
by Allen D. Everett (Author), D. Scott, M.D. Lim (Author), Paul Burns (Illustrator), Jasper Burns (Illustrator), Marcia L. Buck (Illustrator), Jane E., M.D. Crosson (Illustrator)

An indispensable portable teaching tool - it has changed the way congenital heart disease is taught. View Details


Diagnosis and Management of Adult Congenital Heart Disease, 3e
by Michael A. Gatzoulis MD PhD FACC FESC (Author), Gary D. Webb MD CM FACC (Author), Piers E. F. Daubeney DM FRCP FRCPCH (Author)

Designed to meet the needs of clinicians working with adults with congenital heart disease, Diagnosis and Management of Adult Congenital Heart Disease , by Drs. Michael A. Gatzoulis, Gary D. Webb, and Piers E. F. Daubeney, offers essential guidance on the anatomical issues, clinical presentation, diagnosis, and treatment options available to practitioners today. This latest edition features completely updated content, including new information for nurses and nurse practitioners who, now more than ever, are playing an important role in the care of adults... View Details


Congenital Heart Disease: The Catheterization Manual
by Lisa Bergersen (Editor), Susan Foerster (Editor), Audrey C. Marshall (Editor), Jeffery Meadows (Editor)

This practical manual provides a comprehensive overview of how the cardiac catheterization laboratory in a pediatric cardiology division works. Chapters are organized in the order in which a case progresses. Hemodynamics is covered in depth.

View Details


Comprehensive Surgical Management of Congenital Heart Disease, Second Edition
by Richard A Jonas (Author)

Highly Commended, BMA Medical Book Awards 2015

Since the first edition of this book was published in 2004, the management of congenital heart disease has continued to evolve at a rapid pace. Not only have new operations been developed and expanded, such as the intra/extracardiac conduit Fontan and the double root translocation for corrected transposition, but in addition, diagnostic methods―particularly cardiac CT and MRI―have been dramatically transformed.

Understanding of the genetic basis of congenital heart disease and the embryology of cardiac... View Details


Atlas of Congenital Heart Disease Nomenclature: An Illustrated Guide to the Van Praagh and Anderson Approaches to Describing Congenital Cardiac Pathology
by David S. Ezon MD (Author), Jason F. Goldberg MD (Author), William B. Kyle MD (Author)

The Atlas of Congenital Heart Disease Nomenclature uses detailed illustrations and easy to read, bulleted text to instruct readers on the proper way to describe congenital cardiac pathology according to Dr. Richard Van Praagh and Dr. Robert H. Anderson. This groundbreaking resource is the first collaboration between the two anatomists that establishes the correct approach to both nomenclature systems. Each entry was edited by Dr. Van Praagh and Dr. Anderson themselves. Additionally, the text includes essays written by Dr. Van Praagh and Dr. Anderson in their own words to describe their... View Details


Congenital Diseases of the Heart: Clinical-Physiological Considerations
by Abraham Rudolph (Author)

This important revision presents the accumulated knowledge of its highly-regarded author, Dr. Abraham Rudolph, who is internationally recognized as one of the world's leading pioneers in the field of Pediatric Cardiology. Fully revised and updated, the book includes sections considering the changes in pathophysiology with growth into adulthood and the effects of various treatment approaches. The author explains the physiology of normal fetal circulation and the effects of congenital cardiac lesions, with particular reference to the interactions between the lesions and fetal cardiovascular... View Details


Echocardiography in Pediatric and Congenital Heart Disease: From Fetus to Adult
by Wyman W. Lai (Author), Luc L. Mertens (Author), Meryl S. Cohen (Author), Tal Geva (Author)

This comprehensive textbook on the echocardiographic assessment of pediatric and congenital heart disease has been updated for a second edition with an emphasis on new technologies. This highly-illustrated full-color reference contains over 1200 figures, and offers over 600 video clips on a companion website.

Fully updated, with new chapters on the assessment of the post-Fontan procedure patient and on pregnancy and heart disease Each lesion chapter includes new section highlighting the key elements of the echocardiogram(s) Written by experts from the leading centers around the... View Details


Congenital Heart Disease: A Surgical Color Atlas
by A. Sukru Mercan (Author), Zakariya Hubail (Author), S. Yen Ho (Author)

Congenital Heart Disease: A Surgical Color Atlas is a pictorial illustration with over 750 stunning photographs and line drawings that highlight important surgical, anatomic and pathologic points of congenital heart disease. This impressive work by a surgeon, a cardiologist, and a pathologist, features full-color images as seen through the surgeon s eyes, juxtaposed with line drawings to allow for the full examination of anatomic and surgical details. View Details


Color Atlas and Synopsis of Adult Congenital Heart Disease
by Curt Daniels (Author), Ali N Zaidi (Author)

Interpret, diagnose, and treat with this case-based atlas of congenital heart disease

A  Doody's Core Title for 2017!

Color Atlas and Synopsis of Adult Congenital Heart Disease does more than help you interpret imaging studies of congenital heart disease – it also provides evidence-based guidance on the diagnosis and management of patients undergoing these tests.

Presented in a concise, easy-to-read design that is perfect for busy clinicians and intended for family practitioners, internists, pediatricians and general... View Details


Zip-Line
by David Humpherys (Author)

Zip-line is a book for kids that have a scar on their chest from open heart surgery to repair a CHD. Used by families, schools and hospitals, Zip-line whimsically explains the answer to the question "How did that line get there?".

The story centers around a little girl and her bunny rabbit explaining to the reader how she got the scar on her chest and how she isn't any different than anyone else. It shows her unrestricted in activities and features age appropriate illustrations - no blood, or anything remotely graphic. It aims to set a model for kids with a CHD to be comfortable... View Details

Best Science Podcasts 2018

We have hand picked the best science podcasts for 2018. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

The Person You Become
Over the course of our lives, we shed parts of our old selves, embrace new ones, and redefine who we are. This hour, TED speakers explore ideas about the experiences that shape the person we become. Guests include aerobatics pilot and public speaker Janine Shepherd, writers Roxane Gay and Taiye Selasi, activist Jackson Bird, and fashion executive Kaustav Dey.
Now Playing: Science for the People

#478 She Has Her Mother's Laugh
What does heredity really mean? Carl Zimmer would argue it's more than your genes along. In "She Has Her Mother’s Laugh: The Power, Perversions, and Potential of Heredity", Zimmer covers the history of genetics and what kinship and heredity really mean when we're discovering how to alter our own DNA, and, potentially, the DNA of our children.