Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
권호 표지

성인 선천성 심장병 환자의 관리

Medical management of adults with congenital heart disease

  • 강이석 (성균관의대 삼성서울병원 소아과)
  • Kang, I-Seok (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 투고 : 2006.05.01
  • 심사 : 2006.08.01
  • 발행 : 2006.09.15
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초록

The population of adult patients with congenital heart disease(CHD) has increased dramatically because of improved survival of infants and children with CHD. There are still a substantial number of adults with unrepaired CHD. Many adult patients do not know the possible problems of their disease such as ventricular dysfunction, arrhythmia, and what they should pay attention to. They often consider themselves "cured" or "healthy" if only they don't have overt symptoms, and visit hospitals only after deterioration of their problems. Some patients are neglected because they cannot be corrected surgically although careful medical support can improve their survival and quality of life. It is, therefore, essential that the patients, their families, and physicians understand the potential problems of CHD and need for regular follow-up. In this paper we will take a brief review for common medical problems of repaired or unrepaired CHD and also mention a few specific diseases which are common in adults.

키워드

참고문헌

  1. Roos-Hesselink J, PErlroth MG, McGhie J, Spitaels S. Atrial arrhythmias in adults after repair of tetralogy of Fallot. Correlations with clinical, exercise, and echocardiographic findings. Circulation 1995;91:2214-9 https://doi.org/10.1161/01.CIR.91.8.2214
  2. Thorne SA, Barnes I, Cullinan P, Somerville J. Amiodarone-associated thyroid dysfunction : risk factors in adults with congenital heart disease. Circulation 1999;100:149-54 https://doi.org/10.1161/01.CIR.100.2.149
  3. Triedman JK, Bergau DM, Saul JP, Epstein MR, Walsh EP. Efficacy of radiofrequency ablation for control of intraatrial reentrant tachycardia in patients with congenital heart disease. J Am Coll Cardiol 1997;30:1032-8 https://doi.org/10.1016/S0735-1097(97)00252-0
  4. Perloff JK. Systemic complications of cyanosis in adults with congenital heart disease. Hematologic derangement, renal function, and urate metabolism. Cardiol Clin 1993;11:689-99 https://doi.org/10.1016/S0733-8651(18)30147-4
  5. Henriksson P, Varendh G, Lundstrom NR. Haemostatic defects in cyanotic congenital heart disease. Br Heart J 1979;41:23-7 https://doi.org/10.1136/hrt.41.1.23
  6. Ross EA, Perloff JK, Danovitch GM, Child JS, Canobbio MM. Renal function and urate metabolism in late survivors with cyanotic congenital heart disease. Circulation 1986;73:396-400 https://doi.org/10.1161/01.CIR.73.3.396
  7. Presbitero P, Somerville J, Stone S, Aruta E, Spiegelhalter D, Rabajoli F. Pregnancy in cyanotic congenital heart disease. Outcome of mother and fetus. Circulation 1994;89:2673-6 https://doi.org/10.1161/01.CIR.89.6.2673
  8. Siu SC, Sermer M, Harrison DA, Grigoriadis E, Liu G, Sorensen S, et al. Risk and predictors for pregnancyrelated complications in women with heart disease. Circulation 1997;96:2789-94 https://doi.org/10.1161/01.CIR.96.9.2789
  9. Daliento L, Somerville J, Presbitero P, Menti L, Brach-Prever S, Rizzoli G, et al. Eisenmenger syndrome. Factors relating to deterioration and death. Eur Heart J 1998;19:1845-55 https://doi.org/10.1053/euhj.1998.1046
  10. Sader L, McCowan L, White H, Stewart A, Bracken M, North R. Pregnancy outcomes and cardiac complications in women with mechanical bioprosthetic and homograft valves. Br J Obstet Gynaecol 2000;107:245-53 https://doi.org/10.1111/j.1471-0528.2000.tb11696.x
  11. Vitale N, De Feo M, De Santo LS, Pollice A, Tedesco N, Cotrufo M. Dose-dependent fetal complications of warfarin in pregnant women with mechanical heart valves. J Am Coll Cardiol 199;33:1637-41 https://doi.org/10.1016/S0735-1097(99)00044-3
  12. Task Force Members on Infective Endocarditis of the European Society of Cardiology. Guidelines on prevention, diagnosis and treatment of infective endocarditis executive summary; the task force on infective endocarditis of the European society of cardiology. Eur Heart J 2004;25:267-76 https://doi.org/10.1016/j.ehj.2003.11.008
  13. Perloff JK, Child JS. Perloff JK, editor. Noncardiac surgery. Congenital Heart Disease in Adults. 2nd Edn. Philadelphia :Sanders 1998:291-9
  14. Sklansky MS. Guidelines for exercise and sports in children and adolescents with congenital heart disease. Prog Paediatr Cardiol 1993;2:55-66 https://doi.org/10.1016/1058-9813(93)90057-7
  15. The Task Force members of the European Society of Cardiology. Management of grown up congenital heart disease. Eur Heart J 2003;24:1035-84 https://doi.org/10.1016/S0195-668X(03)00131-3
  16. Gatzoulis MA, Till JA, Somerville J, Redington AN. Mechanoelectrical interaction in tetralogy of Fallot. QRS prolongation relates to right ventricular size and predicts malignant ventricular arrhythmias and sudden death. Circulation 1995;92:231-7 https://doi.org/10.1161/01.CIR.92.2.231
  17. Bonhoeffer P, Boudjemline Y, Saliba Z, Merckx J, Aggoun Y, Bonnet D, et al. Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction. Lancet. 2000;356:1403-5 https://doi.org/10.1016/S0140-6736(00)02844-0
  18. Fontan F, Kirklin JW, Fernandez G, Costa F, Naftel DC, Tritto F, Blackstone EH. Outcome after a 'perfect' Fontan operation. Circulation 1990;81:1520-36 https://doi.org/10.1161/01.CIR.81.5.1520
  19. Van Arsdell GS. Williams WG. Freedom RM. A practical approach to 1 1/2 ventricle repairs. Annals of Thoracic Surgery 1998;66:678-80 https://doi.org/10.1016/S0003-4975(98)00584-0
  20. Peters NS, Somerville J. Arrhythmias after the Fontan procedure. Br Heart J 1992;68:199-204 https://doi.org/10.1136/hrt.68.8.199
  21. Kaulitz R, Luhmer I, Bergmann F, Rodeck B, Hausdorf G. Sequelae after modified Fontan operation : Postoperative haemodynamic data and organ function. Heart 1997;78:154-9
  22. Mertens L, Hagler DJ, Sauer U, Somerville J, Gewillig M. Protein-losing enteropathy after the Fontan operation : An international multicenter study. PLE study group. J Thorac Cardiovasc Surg 1998;115:1063-73 https://doi.org/10.1016/S0022-5223(98)70406-4