Elsevier

JACC: Heart Failure

Volume 8, Issue 2, February 2020, Pages 87-99
JACC: Heart Failure

Mini-Focus Issue: Congenital Heart Disease
State-of-the-Art Review
Advanced Heart Failure in Adults With Congenital Heart Disease

https://doi.org/10.1016/j.jchf.2019.08.012Get rights and content
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Highlights

  • Heart failure is the leading cause of death for adults with congenital heart disease.

  • Management of advanced heart failure is complicated and requires a collaborative effort.

  • Appropriately identified patients can successfully undergo heart transplantation or mechanical circulatory support.

  • Multicenter studies and continued multidisciplinary education are needed to improve outcomes.

Abstract

As a result of improvements in care for patients with congenital heart disease (CHD), >90% of children born with CHD are expected to survive to adulthood. For those adults, heart failure (HF) is the leading cause of death. Advances in recognition of, and treatments for, these patients continue to improve. Specifically, adults with CHD are candidates for both heart transplantation and mechanical circulatory support. However, challenges remain that require investigation to improve outcomes.

Key Words

ACHD
congenital
heart
transplant
ventricular assist device

Abbreviations and Acronyms

CHD
congenital heart disease
FALD
Fontan-associated liver disease
HF
heart failure
HT
heart transplantation
MCS
mechanical circulatory support
NYHA
New York Heart Association
PH
pulmonary hypertension
PLE
protein-losing enteropathy
PVR
pulmonary vascular resistance
SV
single-ventricle
TGA
transposition of the great arteries

Cited by (0)

Drs. Lindenfeld, Menachem, and Zalawadiya have served as consultants for Abbott. Dr. Lindenfeld has served as consultant for AstraZeneca, Abbott, Boehringer Ingelheim, Edwards Lifesciences, Novartis, VWave, Relypsa, Impulse Dynamics, and CVRx; and has received grant funding from AstraZeneca. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Barry Greenberg, MD, served as Guest Editor for this paper.