Grown-up congenital heart disease: The problem of late arrhythmia and ventricular dysfunction

Abstract 

Early surgical mortality in congenital heart disease is approaching the low single figures, and medical attention is now focused on long-term evolution. The late outcomes of patients with tetralogy of Fallot, the Fontan operation and congenitally corrected transposition are reviewed with special attention on the development of cardiac arrhythmia and ventricular dysfunction which are the most frequent life-threatening complications in grown-up survivors with congenital heart disease.

A close relationship between residual or late acquired structural lesions and the onset of ventricular dysfunction and electrical problems is a common finding in all groups. Likewise, late arrhythmia led to bad hemodynamics and both result in further deterioration of ventricular function. This highlights the importance and inter-dependence of form and function on late outcome of these complex lesions.

The understanding and critical analysis of the late problems in patients with congenital heart disease are essential to the design of more insightful medical strategies in the years ahead.

Keywords: Tetralogy of Fallot, The Fontan operation, Congenitally corrected transposition, Long-term results in congenital heart disease, Arrhythmia in congenital heart disease, Ventricular dysfunction in congenital heart disease