Adolescents with congenital heart diseases

The remarkable improvement in pediatric cardiosurgery observed over the last few decades has meant that many patients with congenital heart diseases have entered adult life. The growing population of adults with congenital heart defects (ACHD) requires specialized treatment. The team of specialists should consist of cardiologists experienced in congenital heart diseases, cardiosurgeons, obstetricians and anesthesiologists. The need for providing ACHD with appropriate healthcare remains largely unmet. The proper care of ACHD requires an excellent knowledge of defect residuals and post-operative sequel complications. The commonest clinical problems are arrhythmias, impulse formation and conduction disorders as well as heart failure with complicated pathophysiology. The medical management of these patients is mainly based on doctors' experience, since Evidence Based Medicine recommendations do not cover the above mentioned clinical issues. Cyanosis must be distinguished as another clinical problem for which treatment requires special knowledge. For many women with congenital heart diseases, pregnancy and delivery may be hazardous. To date, observations show that most patients with congenital heart diseases enjoy a full life. (Cardiol J 2010; 17, 1: 11-19)