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Recent Advances in Adult Congenital Heart Disease Cardiovascular Medicine

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A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Pediatric Cardiology and Congenital Heart Disease".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 6932

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Special Issue Editors

Dr. Gabriele Egidy Assenza

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Guest Editor

Pediatric Cardiology, Pediatric Cardiac Surgery and Adult Congenital Heart Disease Program, Department of Cardio—Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero—Universitaria di Bologna, Via G. Massarenti, 9, 40138 Bologna, Italy
Interests: adult congenital heart disease; pregnancy and cardiovascular disease; interventional cardiology; quality and outcome

Dr. Emanuela Concetta D’Angelo

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Guest Editor

Special Issue Information

Dear Colleagues,

As you well know, the landscape of adult congenital heart disease (ACHD) cardiovascular medicine is a rapidly evolving field. Worldwide patient complexity is increasing with a parallel increase in the risk of cardiovascular complications and mortality. Structured follow-up by ACHD certified cardiologists is required for selected patients with high complexity, but mild or moderate complex patients are often followed by non ACHD-expert cardiologists. Proper delivery of clinical care, however, does imply some background knowledge of ACHD-specific cardiovascular features. In addition, proper referral to surgical and transcatheter techniques is pivotal, as is proper timing for referring selected patients to heart transplant centers when necessary. Moreover, new cardiovascular drugs have been developed, tested, and introduced into practice in the acquired cardiovascular disease arena, but limited data exist regarding use of such therapies in our field.

To enhance awareness of ACHD as a subspecialty of modern cardiology, this Special Issue aims to collect articles describing different ACHD-related features, including but not limited to research articles and review papers.

We are pleased to invite you, as a key opinion leader in this field, to contribute to this issue, and we welcome the participation of related scholars and experts.

We would like to propose a specific topic for you, but feel free to modify the title and subject based on your expertise.

Dr. Gabriele Egidy Assenza
Dr. Emanuela Concetta D'Angelo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

adult congenital heart disease
multimodality cardiac imaging
heart failure
cardiac transplantation
pregnancy and cardiovascular disease
cardiac surgery
transcatheter intervention

Published Papers (4 papers)

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Research

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10 pages, 1063 KiB

Open AccessEditor’s ChoiceArticle

Changes in the Cath Lab in the Treatment of Adult Patients with Congenital Heart Disease: A 12-Year Experience in a Single Referral Center with the Establishment of a Dedicated Working Group

by Maria Giulia Gagliardi, Roberto Formigari, Marco Alfonso Perrone, Elettra Pomiato, Francesca Fanisio, Mario Panebianco, Rosaria Barracano, Paolo Guccione, Rosalinda Palmieri, Massimiliano Raponi and Lorenzo Galletti

J. Cardiovasc. Dev. Dis. 2023, 10(8), 314; https://doi.org/10.3390/jcdd10080314 - 25 Jul 2023

Cited by 1 | Viewed by 1136

Abstract

Background: Adults with congenital heart disease (ACHD) are a growing population needing ongoing care. The aim of this study was to investigate if a dedicated ACHD team impacted the timing and indication of invasive cardiology procedures in these patients at our hospital. Methods: Our retrospective single-center study enrolled adult patients with moderate or complex congenital heart disease and with at least one cardiac catheterization between January 2010 and December 2021. According to the period, procedures were labeled as group A (2010 to 2015) or group B (2016 to 2021) and further divided into diagnostic (DCC) and interventional cardiac catheterizations (ICC). Results: 594 patients were eligible for the study. Both DCC (p < 0.05) and ICC increased between groups A and B (p < 0.05). In group B: Fontan patients accounted for the majority of DCC (p < 0.001), while DCC decreased in arterial switch repair (p < 0.001). In Fontan patients, conduit stenting was prevalent (p < 0.001), while fenestration closures dropped (p < 0.01). In patients with tetralogy of Fallot and native outflow tract, percutaneous pulmonary valve implantations (PPVI) increased, with a concurrent reduction in pulmonary valve replacements (p < 0.001 vs. surgical series). In right ventricular conduits, ICC increased (p < 0.01), mainly due to PPVI. Among Mustard/Senning patients, baffle stenting increased from Group A to Group B (p < 0.001). In patients with pulmonary atresia and biventricular repair, ICC often increased for pulmonary artery stenting. Conclusions: A dedicated working group could improve ACHD patients’ indications for interventional procedures, leading to tailored treatment, better risk stratification and optimizing time until heart transplantation. Full article

(This article belongs to the Special Issue Recent Advances in Adult Congenital Heart Disease Cardiovascular Medicine)

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10 pages, 5127 KiB

Open AccessArticle

Visibility of Pulmonary Valve and Pulmonary Regurgitation on Intracardiac Echocardiography in Adult Patients with Tetralogy of Fallot

by Ichiro Sakamoto, Kenichiro Yamamura, Ayako Ishikita, Kisho Ohtani, Shintaro Umemoto, Hidetaka Kaku, Yuzo Yamasaki, Kohtaro Abe, Tomomi Ide and Hiroyuki Tsutsui

J. Cardiovasc. Dev. Dis. 2023, 10(1), 24; https://doi.org/10.3390/jcdd10010024 - 7 Jan 2023

Viewed by 1488

Abstract

Pulmonary regurgitation (PR) is a risk factor for sudden cardiac death in adult patients with repaired tetralogy of Fallot (TOF). However, transthoracic echocardiography (TTE) cannot fully visualize the pulmonary valve (PV) and PR. We investigated whether intracardiac echocardiography (ICE) could visualize the PV and PR better than TTE. Thirty adult patients with TOF (mean age 33 ± 15 years) scheduled for cardiac catheterization underwent ICE. The visualization of PV and the severity of PR were classified into three grades. ICE depicted the PV better than TTE (ICE vs. TTE: not visualized, partially visualized, and fully visualized: n = 1 [3%], n = 13 [43%], and n = 16 [53%] vs. n = 14 [47%], n = 13 [43%], and n = 3 [10%], p < 0.001). Especially in patients after pulmonary valve replacement (PVR), the PV was more fully visualized by ICE. The assessment of PR by TTE underestimated the severity of PR in comparison to cardiac magnetic resonance imaging (MRI) (severe PR: 8 [28%] vs. 22 [76%], p = 0.004), while there was no discrepancy between the results of ICE and MRI (21 [72%] vs. 22 [76%], p = 1.000). In comparison to TTE, ICE can safely provide better visualization of the PV and PR in adults with TOF, especially in patients who have undergone PVR. Full article

(This article belongs to the Special Issue Recent Advances in Adult Congenital Heart Disease Cardiovascular Medicine)

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Review

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16 pages, 360 KiB

Open AccessReview

Cardiac Drugs in ACHD Cardiovascular Medicine

by Magalie Ladouceur, Estibaliz Valdeolmillos, Clément Karsenty, Sébastien Hascoet, Pamela Moceri and Laurianne Le Gloan

J. Cardiovasc. Dev. Dis. 2023, 10(5), 190; https://doi.org/10.3390/jcdd10050190 - 24 Apr 2023

Cited by 1 | Viewed by 1923

Abstract

Adult congenital heart disease (ACHD) is a growing population that requires life-long care due to advances in pediatric care and surgical or catheter procedures. Despite this, drug therapy in ACHD remains largely empiric due to the lack of clinical data, and formalized guidelines on drug therapy are currently lacking. The aging ACHD population has led to an increase in late cardiovascular complications such as heart failure, arrhythmias, and pulmonary hypertension. Pharmacotherapy, with few exceptions, in ACHD is largely supportive, whereas significant structural abnormalities usually require interventional, surgical, or percutaneous treatment. Recent advances in ACHD have prolonged survival for these patients, but further research is needed to determine the most effective treatment options for these patients. A better understanding of the use of cardiac drugs in ACHD patients could lead to improved treatment outcomes and a better quality of life for these patients. This review aims to provide an overview of the current status of cardiac drugs in ACHD cardiovascular medicine, including the rationale, limited current evidence, and knowledge gaps in this growing area. Full article

(This article belongs to the Special Issue Recent Advances in Adult Congenital Heart Disease Cardiovascular Medicine)

17 pages, 658 KiB

Open AccessReview

Reproductive Health in Congenital Heart Disease: Preconception, Pregnancy, and Postpartum

by Dan G. Halpern, Christina A. Penfield, Jodi L. Feinberg and Adam J. Small

J. Cardiovasc. Dev. Dis. 2023, 10(5), 186; https://doi.org/10.3390/jcdd10050186 - 22 Apr 2023

Viewed by 1808

Abstract

The prevalence of congenital heart disease (CHD) in pregnancy is rising due to the improved survival of patients with CHD into childbearing age. The profound physiological changes that occur during pregnancy may worsen or unmask CHD, affecting both mother and fetus. Successful management of CHD during pregnancy requires knowledge of both the physiological changes of pregnancy and the potential complications of congenital heart lesions. Care of the CHD patient should be based on a multidisciplinary team approach beginning with preconception counseling and continuing into conception, pregnancy, and postpartum periods. This review summarizes the published data, available guidelines and recommendations for the care of CHD during pregnancy. Full article

(This article belongs to the Special Issue Recent Advances in Adult Congenital Heart Disease Cardiovascular Medicine)

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