Long term morbidity and mortality in Adult Congenital Heart Disease (ACHD) patients

Abstract

Congenital heart disease (CHD) affects 1 in 1000 births. Improved antenatal diagnosis, surgical techniques and post-natal care has meant that adults with CHD now outnumber paediatric CHD patients with an estimated 13 million adults worldwide. Despite this improvement in survival, the long-term morbidity and mortality of many congenital abnormalities are yet to be documented and expectations of patients transitioning to adulthood defined. To serve the increasing numbers of adults with CHD, subspecialty Adult Congenital Heart Disease clinics are being established. Informing these clinicians and their patients of the expectations of adulthood with CHD is required. In this thesis, we report on the morbidity and mortality of adults with specific repaired CHD heart lesions. We discuss the complications which adults with these lesions can expect and then assess possible predictors of these complications. Finally, we design and implement a study to assess for anatomical and functional sequelae of surgical techniques used to treat a specific underlying congenital heart lesion, in a novel objective and scientific way.