| Feature | Details |
|---|---|
Patient assessment | residual disease and sequelae vary with the underlying lesion and its severity; each patient must be assessed individually. |
Management plan | the plan should be agreed with the patient and include short- and long-term goals and the timing of transition to adult care. |
Education and employment | both may be adversely affected, and occupational activity levels need assessment. |
| Feature | Details |
|---|---|
Pre-operative planning | surgery for associated congenital abnormalities carries increased risks and requires careful assessment. |
Thrombotic and embolic risks | thrombosis and embolism from synthetic shunts or patches are recognised risks. |
Fluid-related risk | fluid shifts may cause volume overload. |
Cosmetic concerns | operative approaches should consider concerns such as the implantation site of an abdominal generator. |
| Feature | Details |
|---|---|
Mild or repaired defects | patients can undertake moderately vigorous exercise. |
Complex disease | complex defects, cyanosis, ventricular dysfunction or arrhythmias require specialist evaluation and individualised exercise advice. |
Genetic contribution | between 10% and 15% have a genetic basis, which should be assessed for implications for the patient's future children. |
Genetic evaluation | assessment includes family history, evaluation of syndromic versus non-syndromic disorders and, sometimes, cytogenetics. |
| Feature | Details |
|---|---|
Understanding prognosis | some adolescents with complex disorders mistakenly believe they have been cured; transition may be their first opportunity to receive information about mortality. |
Decision-making | expectations about life expectancy need to be managed, and adolescents are often willing to discuss these issues and participate in decisions. |