Echocardiographic Follow-up of Grown-ups with Congenital Heart Disease: Update 2013
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ECHOCARDIOGRAPHY (T BUCK, SECTION EDITOR)
Echocardiographic Follow-up of Grown-ups with Congenital Heart Disease: Update 2013 Doreen DeFaria Yeh & Mary Etta King
Published online: 30 October 2013 # Springer Science+Business Media New York 2013
Abstract There is a burgeoning population of adults with congenital heart disease (CHD) due to successful medical and surgical intervention in childhood. This group of patients requires careful echocardiographic evaluation and follow-up of the residua and sequellae of their cardiac anomalies. This review addresses the guidelines for evaluation and management of the grown-up with CHD, the contributions of 3D echo in their assessment, and the current status and new developments in noninvasive determination of ventricular volumes and function. The contribution of stress and contrast echocardiography for the adult with CHD is considered. The application of transcatheter interventions for this population is included with particular regard for the role of echocardiography pre- and postprocedure. Particular problems presented by pregnancy for the adult CHD patient are also reviewed.
D-TGA L-TGA LV PA PFO PR PW RV TEE TOF VSD
D transposition of the great arteries L transposition (or congenitally corrected) transposition of the great arteries Left ventricle Pulmonary artery Patent foramen ovale Pulmonic regurgitation Pulsed wave Right ventricle Transesophageal echocardiogram Tetralogy of Fallot Ventricular septal defect
Introduction Keywords Echocardiography . Adult congenital heart disease . Interventional echocardiography . Stress echo . Pregnancy and heart disease Abbreviations 2D Two-dimensional 3D Three-dimensional ASD Atrial septal defect CHD Congenital heart disease CMR Cardiac magnetic resonance imaging
D. DeFaria Yeh Division of Cardiology, Adult Congenital Heart Disease Program, Echocardiography Section, Massachusetts General Hospital, 55 Fruit St, Yawkey 5700, Boston, MA 02114, USA M. E. King (*) Division of Pediatric Cardiology, Cardiac Ultrasound Laboratory, Massachusetts General Hospital for Children, 55 Fruit St, Boston, MA 02114, USA e-mail: [email protected]
As a result of medical and surgical advancements, there are an increasing number of adults living with congenital heart disease (CHD). The prevalence of CHD in the adult population is now estimated at 3.0 per 1000 adults, based upon data from several cross-sectional population databases [1–4]. This expanding demographic is exemplified in Fig. 1 as reported by Marelli and colleagues [2] from a Canadian administrative database, with adults representing more than 50 % of the cases recorded for each study point in time. Hence, the practicing cardiologist can expect to be called upon with increasing frequency to evaluate and follow adults with CHD, either unrepaired or modified by surgery or transcatheter techniques. Echocardiography remains the primary diagnostic imaging modality for assessing and following these patients. This review will address the echocardiographic evaluation of the adult patient with CHD,
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