The classical statistics says Congenital heart disease occurs .8/1000 in general population. Survival into adult hood is an entirely different story .In the last half a century , cardiac surgeons ably assisted by anestheteists (Most dedicated ,Hats off !) , interventional cardiologists (With some conflicts !) have lifted up the survival curve of all sort of congenital heart disease.
We have now complete cure for many of the dreaded diseases of the past .Currently ,most cases of TOF, VSD, ASD , Co-arctation of aorta, bulk of the TGVs , DORVs are correctible.Only patients with severe forms of hypoplastiv LV, pulmonary atresias and complex outflow defects are facing death in infancy.
However , these patients often require prolonged follow up and may require staged surgeries, especially who undergo univentricualr repair for complex cyanotic diseases .Some require fine tuning of the anatomical conduits etc as dictated by the growth of child. Few may develop complications in adult hood .
This may be due to
- Added hemodynamic stress
- Infection of the biological or synthetic material used .
- Few will show progression of the native disease .
The timing of release of this guideline could not be more appropriate . In this hi -tech pediatric cardiology era , we are talking about cardiac transplantation for complex CHD , where surgery is not possible or has unacceptable mortality .
ESC has updated the version in 2010. Let us enjoy this 43 page treasure , gifted to cardiac physicians, surgeons and the fellows !
Link placed here with the due courtesy of ESC