Abstract
Diagnosis and treatment of congenital heart disease (CHD) in adult patients is an actual problem that
requires improving approaches to the tactics of medical care. A special group in this litter is the unopened,
newly identified CHD. In majority of cases, there are septal defects with arteriovenous shunting of blood and
an increase in pulmonary blood flow. Features and differences in this group are connected with complications
of long natural course, combined pathology and risks associated with surgical correction. Distinctive
features of the tactics in this patients affect not only surgical, but also conservative treatment. The analysis of
the literature devoted to specific features, their structure, the effect on the clinical course of congenital heart
defects and the prognosis
References
- Popelova J., Oechslin E. Congenital heart disease in
adults. Informa UK Ltd; 2008.
- Gatzoulis M.A., Swan L. Adult congenital heart disease.
A practical guide. Blackwell Publishing Ltd; 2005.
- Khairy P., Van Hare G., Balaji S., Berul Ch., Cecchin
F., Cohen M.I. et al. PACES/HRS Expert
Consensus Statement on the Recognition and
Management of Arrhythmias in Adult Congenital Heart
Disease: developed in partnership between the Pediatric
and Congenital Electrophysiology Society (PACES)
and the Heart Rhythm Society (HRS). Endorsed by the
governing bodies of PACES, HRS, the American
College of Cardiology (ACC), the American Heart
Association (AHA), the European Heart Rhythm
Association (EHRA), the Canadian Heart Rhythm
Society (CHRS), and the International Society for
Adult Congenital Heart Disease (ISACHD). Heart
Rhythm. 2014; 11 (10): e102–65. DOI: 10.1016/
j.hrthm.2014.05.009
- Dreyfus G.D., Corbi P.J., Chan K.J., Bahrami T.
Secondary tricuspid regurgitation or dilatation: which
should be the criteria for surgical repair? Ann. Thorac.
Surg. 2005; 79 (Issue 1): 127–32. DOI: 10.1016/
j.athoracsur.2004.06.057
- Campbell M. Natural history of atrial septal defect.
Br. Heart J. 1970; 32 (6): 820–6.
- Gierat-Haponiuk K., Haponiuk I., Szalewska D.,
Chojnicki M., Jaworski R., Niedoszytko P. et al. Effect
of complex cardiac rehabilitation on physical activity
and quality of life during long-term follow-up after surgical
correction of congenital heart disease. Kardiol.
Pol. 2015; 73 (4): 267–73. DOI: 10.5603/KP.a2014.
0206
- Lechat P., Mas J.L., Lascault G., Loron P., Theard M.,
Klimczac M. et al. Prevalence of patent foramen ovale
in patients with stroke. N. Engl. J. Med. 1988; 318 (18):
1148–52. DOI: 10.1056/NEJM198805053181802
8. Webster M.W., Chancellor A.M., Smith N.J., Swift D.L.,
Sharpe D.N., Bass N.M., Glasgow G.L. Patent foramen
ovale in young stroke patient. Lancet. 1988; 2 (8601): 11–2.
- Ammash N.M., Warnes C.A. Ventricular septal defects
in adults. Ann. Intern. Med. 2001; 135: 812–24. DOI:
10.7326/0003-4819-135-9-200111060-00011
- Mukimov F.H., Gogbachevskiy S.V. Surgical treatmentof ventricular septal defect complicated withEisenmenger syndrome. Detskie Bolesni Serdtsa iSosudov (Children's Heart and Vascular Diseases). 2014;1: 17–22 (in Russ.).
- Neumayer U., Stone S., Somerville J. Small ventricular
septal defects in adults. Eur. Heart J. 1998; 19: 1573–82.
DOI: 10.1053/euhj.1998.1083
- Karonis T., Scognamiglio G., Babu-Narayan S.V.,
Montanaro C., Uebing A., Diller G.P. et al. Clinical
course and potential complications of small VSD in
adulthood: Late development of left ventricular dysfunction
justifies lifelong care. Int. J. Cardiol. 2016; 208:
102–6. DOI: 10.1016/j.ijcard.2016.01.208
- Bockeria L.А., Golukhova Е.Z., Chigogidze N.А., So-bolev А.V., Kakuchaya Т.Т., Gegechkori N.R. Arrhythmo-genic syndrome in adults with ASD. Bakoulev Journalfor Cardiovascular Diseases. 2008; 9 (6): 7–10 (in Russ.).
- Bockeria L.А., Golukhova Е.Z., Gegechkori N.R.,Dadasheva M.A., Chigogidze N.А., Sobolev А.V.,Kakuchaya T.T. Features and treatment of arrhythmia inadults with ASD. Annaly Aritmologii (Annals ofArrhythmology). 2007; 3: 5–12 (in Russ.)
- Silversides C.K., Haberer K., Siu S.C., Webb G.D.,
Benson L.N., McLaughlin P.R., Harris L. Predictors of
atrial arrhythmias after device closure of secundum type
atrial septal defects in adults. Am. J. Cardiol. 2008; 101
(Issue 5): 683–7. DOI: 10.1016/j.amjcard.2007.10.035
- Giamberti A., Chessa M., Abella R., Butera G., Negura
D., Foresti S. et al. Surgical treatment of arrhythmias
in adults with congenital heart defects. Int. J. Cardiol.
2008; 129: 37–41. DOI: 10.1016/j.ijcard.2007.06.019
- Baumgartner H., Bonhoeffer Ph., De Groot N.M.,
de Haan F., Deanfield J.E., Galie N. et al. Guidelines
for the management of grown-up congenital heart disease
(new version 2010): The task force on the management
of grown-up congenital heart disease of the
European Society of Cardiology. Eur. Heart J. 2010; 31
(23): 2915–57. DOI: 10.1093/eurheartj/ehq249
- Freeman M.L., Landolfo C., Safford R.E., Keller C.A.,
Heckman M.G., Burger C.D. Noninvasive assessment
of right heart function and hemodynamics during exercise
in patients with pulmonary arterial hypertension.
South. Med. J. 2013; 106 (2): 141–6. DOI: 10.1097/
SMJ.0b013e3182805165
- Opotowsky A.R. Clinical evaluation and management
of pulmonary hypertension in the adult with congenital
heart disease. Circulation. 2015; 131: 200–10. DOI:
10.1161/CIRCULATIONAHA.114.006976
- Vogel M., Berger F., Kramer A., Alexi-Meshkishvili V.,
Lange P. Incidence of secondary pulmonary hypertension
in adults with atrial septal or sinus venosus defects.
Heart. 1999; 82:1 30–3. DOI: 10.1136/hrt.82.1.30
- Engelfriet P., Boersma E., Oechslin E., Tijssen J.,
Gatzoulis M.A. The spectrum of adult congenital heart
disease in Europe: morbidity and mortality in a 5 year
follow-up period. Eur. Heart J. 2005; 26 (21): 2325–33.
DOI: 10.1093/eurheartj/ehi396
- Berger F., Ewert P. Atrial septal defect: waiting for
symptoms remains an unsolved medical anachronism.
Eur. Heart J. 2011; 32 (5): 531–4. DOI: 10.1093/eurheartj/
ehq377
- Yong G., Khairy P., De Guise P., Dore A., Marcotte F.,
Mercier L.A. et al. Pulmonary arterial hypertension in
patients with transcatheter closure of secundum atrial
septal defects. Circ. Cardiovasc. Interv. 2009; 2:
455–62. DOI: 10.1161/CIRCINTERVENTIONS.108.
826560
- Lowe B.S., Therrien J., Ionescu-Ittu R. Diagnosis of
pulmonary hypertension in the congenital heart disease
adult population: Impact on outcomes. J. Am. Coll.
Cardiol. 2011; 58 (Issue 5): 538–46. DOI: 10.1016/
j.jacc.2011.03.033
- Diller G.P. Pulmonary vascular disease in adults with
congenital heart disease. Circulation. 2007; 115: 1039–
50. DOI: 10.1161/CIRCULATIONAHA.105. 592386
- Duffelsa M.G.J., Engelfriet P.M., Berger R.M.F.,
van Loon R.L.E., Hoendermis E., Vriend J.W.J. et al.
Pulmonary arterial hypertension in congenital heart
disease: An epidemiologic perspective from a Dutch
registry. Int. J. Cardiol. 2007; 120 (Issue 2): 198–204.
DOI: 10.1016/j.ijcard.2006.09.017
- Verheugt C.L., Uiterwaal C., van der Velde E.T.,
Meijboom F.J., Pieper P.G., van Dijk A.P. et al.
Mortality in adult congenital heart disease. Eur. Heart J.
2010; 31 (10): 1220–9. DOI: 10.1093/eurheartj/ehq032
- Oliver J.M., Gallego P., González A.E., Benito F.,
Sanz E., Aroca A. et al. Surgical closure of atrial defects
before or after the age of 25 years. Comparison with the
natural history of unoperated patients. Rev. Esp.
Cardiol. 2002; 55: 953-61. DOI: 10.1016/S0300-
8932(02)76734-1
- Podzolkov V.P., Zelenikin M.M., Pursanov M.G.,Kupryashov A.A., Orozmatov T.T., Dontsova V.I.Complications of natural course and immediate resultsof surgical treatment of adults patients with ventricularseptal defect. Detskie Bolezni Serdtsa i Sosudov(Children's Heart and Vascular Diseases).2013; 1: 24–9(in Russ.)
- Podzolkov V.P., Bondarev Yu.I., Danilov T.Yu.,Bondarenko I.E., Cheban V.N., Chernykh I.G. Earlyresults of aortic valve repair in patients with ventricularseptal defect and aortic insufficiency. Grudnaya iSerdechno-Sosudistaya Khirurgiya (Russian Journal ofThoracic and Cardiovascular Diseases). 2002; 4: 24–30(in Russ.).
- Podzolkov V.P., Zelenikin M.M. Features of congenitalheart disease in adults. Grudnaya i Serdechno-Sosudistaya Khirurgiya (Russian Journal of Thoracic andCardiovascular Diseases).2009; 2: 41–5 (in Russ.).
- Podzolkov V.P., Alekyan B.G., Chiaureli М.R.,Merzlyakov V.Yu., Zelenikin M.M., Nezhlukto А.А.Surgical treatment of congenital heart disease withcoronary artery disease. Grudnaya i Serdechno-Sosudistaya Khirurgiya (Russian Journal of Thoracic andCardiovascular Diseases). 2009; 3: 4–6 (in Russ.).
- Podzolkov V.P., Alekyan B.G., Zelenikin M.M.,Pursanov M.G., Nezhlukto А.А., Petrosyan K.V.Transcatheter closure of atrial septal defect with coro-nary revascularization. Grudnaya i Serdechno-Sosudistaya Khirurgiya (Russian Journal of Thoracic andCardiovascular Diseases). 2011; 5: 46–50 (in Russ.)
- Ioseliani D.G., Koledinskiy А.G., Koval'chuk I.А.,Abil'dinova А.Zh. Endovascular revascularization andclosing of secondary atrial septal defect: simultaneouslyor separately? Grudnaya i Serdechno-SosudistayaKhirurgiya (Russian Journal of Thoracic andCardiovascular Diseases).2013; 5: 23–6 (in Russ.).
About the authors
Minaev Anton Vladimirovich, Junior Researcher, orcid.org/0000-0001-6456-1905
