Congenital heart disease in 2021: Update on management and outcome

摘要

Current treatment of congenital heart defects allows most patients to survive into late adulthood. Survival and functional capacity are constantly improving as a result of ongoing progress in diagnosis, imaging, medical treatment, interventional procedures, and follow-up. For patients born with "simple" congenital heart defects, a normal life expectancy and quality of life may be expected. For patients with moderate and severe congenital heart defects, however, a wide spectrum of cardiac but also extracardiac anomalies and challenges has become apparent for the growing child and aging adult. These difficulties may significantly impact everyday life. In this state-of-the-art paper, the current principles of patient care for congenital heart defect are detailed. The impact of genetic diagnosis and prenatal screening is discussed. Cardiac prognosis is analyzed in light of recent data on morbidity and mortality, life expectancy re-intervention, and functional capacity. Current knowledge about nutritional and infectious difficulties, neurocognitive disorders, social integration, and quality of life is presented. The importance of a multidisciplinary follow-up, in a specialized setting, is emphasized. Follow-up must be transversal but also longitudinal, in order to support the patient and their family throughout the lifespan. Specialized follow-up must allow for anticipation, detection, and better management of difficulties encountered by the patient and their family.