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Minerva Cardioangiologica 2018 June;66(3):329-36

DOI: 10.23736/S0026-4725.18.04591-7

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Heart failure in grown-up congenital heart disease

Alessia FACCINI, Angelo MICHELETTI, Diana G. NEGURA, Luca GIUGNO, Gianfranco BUTERA, Mario CARMINATI, Alessandro GIAMBERTI, Massimo CHESSA

Pediatric and Adult Congenital Heart Center, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy


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The increasing survival to adulthood of patients with congenital heart disease (CHD) has changed the epidemiology of adult CHD (ACHD) patients and has led to an increment in hospitalization rates due to heart failure (HF). ACHD patients hospitalized for HF have a five-fold higher risk of death than those compensated. HF occurs predominantly in patients with tetralogy of Fallot, single ventricles, and after the Mustard operation for transposition of the great arteries. Diagnostic strategies applied in acquired HF patients are usually used to evaluate ACHD patients, but sometimes this can postpone the identification of HF that can become manifest with unusual and peculiar signs or symptoms. In the same way, therapeutic management resembles the acquired HF one, even if no large randomized clinical trials have been conducted in ACHD patients. Therefore, a close monitoring in dedicated units is mandatory in order to identify in time HF manifestations and manage them adequately.


KEY WORDS: Congenital heart defects - Heart failure - Adult

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