Caring for the Critically Ill Adult Congenital Heart Disease Patient

Overview

Journal Curr Cardiol Rep

Publisher Current Science

Specialty Cardiology & Vascular Diseases

Date 2024 Apr 9

PMID 38592571

Authors

Thomas Das

Penelope Rampersad

Joanna Ghobrial

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: This review aims to discuss the unique challenges that adult congenital heart disease (ACHD) patients present in the intensive care unit.

Recent Findings: Recent studies suggest that ACHD patients make up an increasing number of ICU admissions, and that their care greatly improves in centers with specialized ACHD care. Common reasons for admission include arrhythmia, hemorrhage, heart failure, and pulmonary disease. It is critical that the modern intensivist understand not only the congenital anatomy and subsequent repairs an ACHD patient has undergone, but also how that anatomy can predispose the patient to critical illness. Additionally, intensivists should rely on a multidisciplinary team, which includes an ACHD specialist, in the care of these patients.

References

Shah D, Deo S, Althouse A, Teuteberg J, Park S, Kormos R . Perioperative mortality is the Achilles heel for cardiac transplantation in adults with congenital heart disease: Evidence from analysis of the UNOS registry. J Card Surg. 2016; 31(12):755-764. DOI: 10.1111/jocs.12857. View

Wang A, Book W, McConnell M, Lyle T, Rodby K, Mahle W . Prevalence of hepatitis C infection in adult patients who underwent congenital heart surgery prior to screening in 1992. Am J Cardiol. 2007; 100(8):1307-9. DOI: 10.1016/j.amjcard.2007.05.059. View

Morray B, Dimas V, Lim S, Balzer D, Parekh D, Van Mieghem N . Circulatory support using the impella device in fontan patients with systemic ventricular dysfunction: A multicenter experience. Catheter Cardiovasc Interv. 2017; 90(1):118-123. DOI: 10.1002/ccd.26885. View

Khairy P, Aboulhosn J, Broberg C, Cohen S, Cook S, Dore A . Thromboprophylaxis for atrial arrhythmias in congenital heart disease: A multicenter study. Int J Cardiol. 2016; 223:729-735. DOI: 10.1016/j.ijcard.2016.08.223. View

Vijayakumar N, Badheka A, Chegondi M, McLennan D . Successful use of Protek Duo cannula to provide veno-venous extra-corporeal membrane oxygenation and right ventricular support for acute respiratory distress syndrome in an adolescent with complex congenital heart disease. Perfusion. 2020; 36(2):200-203. DOI: 10.1177/0267659120923880. View

Bacon M, Gray S, Schwartz S, Cooper D . Extracorporeal Membrane Oxygenation (ECMO) Support in Special Patient Populations-The Bidirectional Glenn and Fontan Circulations. Front Pediatr. 2018; 6:299. PMC: 6199392. DOI: 10.3389/fped.2018.00299. View

Buber J, Valle C, Valente A . Common congenital heart problems in acute and intensive care. Eur Heart J Acute Cardiovasc Care. 2023; 12(4):267-279. DOI: 10.1093/ehjacc/zuad030. View

Garcia Gomez M, Uribarri A, San Roman Calvar J, Stepanenko A . Clinical use of percutaneous mechanical circulatory assistance in a patient with end-stage right-sided heart failure and massive tricuspid insufficiency due to congenital heart disease: first-in-the-world case report. Eur Heart J Case Rep. 2021; 5(8):ytab269. PMC: 8364766. DOI: 10.1093/ehjcr/ytab269. View

Tutarel O, Kempny A, Alonso-Gonzalez R, Jabbour R, Li W, Uebing A . Congenital heart disease beyond the age of 60: emergence of a new population with high resource utilization, high morbidity, and high mortality. Eur Heart J. 2013; 35(11):725-32. DOI: 10.1093/eurheartj/eht257. View

10.

Rychik J, Atz A, Celermajer D, Deal B, Gatzoulis M, Gewillig M . Evaluation and Management of the Child and Adult With Fontan Circulation: A Scientific Statement From the American Heart Association. Circulation. 2019; 140(6):e234-e284. DOI: 10.1161/CIR.0000000000000696. View

11.

Dasi L, KrishnankuttyRema R, Kitajima H, Pekkan K, Sundareswaran K, Fogel M . Fontan hemodynamics: importance of pulmonary artery diameter. J Thorac Cardiovasc Surg. 2009; 137(3):560-4. PMC: 3631595. DOI: 10.1016/j.jtcvs.2008.04.036. View

12.

Marino B, Tabbutt S, MacLaren G, Fran Hazinski M, Adatia I, Atkins D . Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease: A Scientific Statement From the American Heart Association. Circulation. 2018; 137(22):e691-e782. DOI: 10.1161/CIR.0000000000000524. View

13.

Siddiqui Z, Chandrakantan A, Hills E, Nguyen C, Todd B, Adler A . Incidence of Difficult Laryngoscopy in Adult Congenital Heart Disease Patients: A Retrospective Cohort Study. J Cardiothorac Vasc Anesth. 2021; 35(12):3659-3664. DOI: 10.1053/j.jvca.2021.07.018. View

14.

Kops S, White S, Klewer S, Andrews J, Seckeler M . ECMO in adults with congenital heart disease - Analysis of a national discharge database. Int J Cardiol Congenit Heart Dis. 2024; 8:100366. PMC: 11657935. DOI: 10.1016/j.ijcchd.2022.100366. View

15.

Saef J, Ghobrial J . Valvular heart disease in congenital heart disease: a narrative review. Cardiovasc Diagn Ther. 2021; 11(3):818-839. PMC: 8261750. DOI: 10.21037/cdt-19-693-b. View

16.

Ho K, Bare I, Sy E, Singh J, Opotowsky A, Dehghani P . Trends in Patient Characteristic, Cost, and Mortality Among Mechanically Ventilated Adult Patients With Congenital Heart Disease in the United States. CJC Open. 2022; 4(2):197-205. PMC: 8843989. DOI: 10.1016/j.cjco.2021.09.024. View

17.

Brida M, Diller G, Gatzoulis M . Systemic Right Ventricle in Adults With Congenital Heart Disease: Anatomic and Phenotypic Spectrum and Current Approach to Management. Circulation. 2018; 137(5):508-518. DOI: 10.1161/CIRCULATIONAHA.117.031544. View

18.

Moran A, Blume E, Quinn R . Intra-aortic balloon pump use in the failing Fontan circulation. Congenit Heart Dis. 2008; 3(1):60-2. DOI: 10.1111/j.1747-0803.2007.00143.x. View

19.

Fuchs M, Connolly H . Ebstein Anomaly in the Adult Patient. Cardiol Clin. 2020; 38(3):353-363. DOI: 10.1016/j.ccl.2020.04.004. View

20.

Mercado A, Well A, Lamari-Fisher A, Mizrahi M, Johnson G, Patt H . Mental health diagnoses in hospitalized adults with congenital heart disease in the state of Texas: A 10-year review. Int J Cardiol Congenit Heart Dis. 2024; 7:100340. PMC: 11658291. DOI: 10.1016/j.ijcchd.2022.100340. View