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Yulius Patimang
30
20
10
0
Age 17-20 Age 21-30 Age 31-40 Age 41-50 Age 51-60 Age 61-65
Severity of GUCH
Patients
65% of GUCH are
moderate to severe
cases
35% 30%
35%
LATE COMPLICATIONS
right heart failure
left heart failure
valvular Pulmonary Hypertension
diseases Infection heart failure
Zaidi AN, Daniels CJ. The Adolescent and adult with congenital heart disease. In: Allen HD et.al (editor). Moss and Adams
heart disease in infants, childrenm and adolescents including the fetus and young adult. Volume 2.8 th edition.
Therapeutic considerations
Infective endocarditis
High risk particularly in:
Cyanotic CHD without surgical repair, residual
defects, palliative shunts
Prostetic valves
Residual defects (generally) after surgical or
cath. closure
Patients with previous IE
general problems
Pregnancy
Generally well tolerated
Extremely High risk (high mortality 30-50%):
Severe pulmonary art. hypertension (Eisenmenger sy)
High risk
Cyanosis (esp. SpO2 <85%)
Stenotic left valve disease (AS, MS)
Poor EF LV (<40%)
Aortic roof dilation (Marfan sy)
Arrhythmias
Specific problems-Atrial septal
defect
Atrial septal Defect
RA LA
RA LA
RV LV
RV LV
Atrial septal defect -
treatment
ASD secundum (if possible catheterisation
device closure is prefer)
Atrial septal defect
During balloon
sizing
Atrial septal defect
RA
LA
RA LA
RV LV RV LV
Ventricular septal defect
Management:
Transcatheter closure
Ventricular septal defect
RA LA
RA LA
RV LV
RV LV
Patent Ductus Arteriosus-
treatment
Device closure is the method of choice
Surgery is reserved for the rare patient with a duct too large
for device closure or with unsuitable anatomy such as
aneurysm formation
Patent Ductus Arteriosus
Patent Ductus Arteriosus
4 anatomic
malformations:
Right Ventricular
Hypertrophy
RVOTO
Overriding of the
aorta
Ventricular Septal
Defect
Tetralogy of Fallot
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