There have recently been serious developments diagnosis and treatment of congenital heart diseases. In parallel to developments in diagnosis and treatment, the children with congenital heart diseases are now able to live until their advanced age. Moreover, the number of patients with congenital heart diseases who were treated and have reached an adult age is expected to be greater than those in childhood. It is estimated that approx. 200.000 adults in our country have a congenital heart disease.
Adult congenital heart diseases can be roughly categorized into two. One group consists of those whose illness had not been recognized and who have recently been diagnosed (the most common types are ASD and bicuspid aortic valve in this group); the other group consists of those who have been followed up and received medication for the disease since their childhood. A number of patients in the second group can be seriously ill patients who have undergone an operation for once or several times while the other group might not have a serious disease requiring an operation.
The patients who have undergone an operation for once or several times, and the patients who have a congenital heart disease with cyanosis, impaired cardiac contraction and higher pulmonary vein pressure are at higher risk. Such patients can develop some other problems over time which can pose a threat to patient life. Some problems which can be easily overcome in childhood become serious at later ages. Although therapeutic interventions at childhood of some patients can be fully corrective, the only goal for other patients is to safely make children survive through their adult age. These patients will have complementary operations, angiography, hospitalization, and follow-up in intensive care when they reach their adult age.
Follow-up and treatment of adult patients with congenital heart disease require particular knowledge and skill. An expert transition clinic must be available to successfully offer these patients services. Adult cardiologists are not experienced enough to deal with complicated and serious problems in adult patients with congenital heart diseases. Pediatric cardiologists are not expected to deal with health problems in adults. For this, pediatric and adult cardiologists need to work as a team.
Adults with congenital heart diseases must be informed in detail about pregnancy, choice of profession, capacity of effort and life style. A large number of female patients can have pregnancy only under controlled conditions. Genetic consultancy is necessary prior to pregnancy of such patients. A risk assessment of patients must be performed, and the patients who are at higher risk must be provided information about birth control and the pregnancy must be terminated when necessary.