THE CONTEXT
Adults with surgically treated congenital heart disease may develop ventricular failure or arrhythmias and require continuing specialist follow-up.
Right ventricular failure
•
A right ventricle connected to the aorta may develop failure in adult life because it is unsuited to functioning at systemic pressures.
•
Right ventricular dilatation and failure may begin when patients are in their twenties or thirties.
Postoperative arrhythmias
•
Surgery involving the atria may be followed by atrial arrhythmias.
•
Ventricular septal defect repair produces a ventricular scar and may be followed by ventricular arrhythmias.
•
Antiarrhythmic drugs and an ICD may be required.
Long-term care
•
Careful follow-up should continue from adolescence throughout adult life to identify problems early and institute appropriate medical or surgical treatment.
•
Management of grown-up congenital heart disease is complex and has developed into a cardiological subspecialty.