Surgery for Adults with Congenital Heart Disease (ACHD)
Increased long-term survival after complex neonatal heart surgery has resulted in a rapidly growing population of adults with congenital heart disease (ACHD).,, This is attributable to several improvements in diagnostic imaging, the advent of prostaglandins, and developments and refinements in surgical technique. In addition, improved perioperative care by dedicated pediatric cardiac anesthesiologists and intensivists have contributed immensely to decreased mortality and morbidity. However, many ACHD patients are subject to progression of their native palliated disease or suffer from sequelae of their childhood repair or require repeat surgical intervention.
Approximately 20% of adults with CHD undergo cardiac surgery in adulthood to treat a combination of congenital and acquired lesions., As such, ACHD surgery is marked by operative complexity coupled with adult-onset comorbidities., These patients may be prone to progression of their native palliated disease or suffer from sequelae of their childhood repair that requires repeat surgical intervention. Surgery for adult congenital cardiac disease poses unique challenges and risks.
Herein, we explore some of the most common ACHD lesions and the variety of surgical approaches that are feasible.
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