New Guidelines Issued for Managing Adult Congenital Heart Disease

New clinical practice guidelines were issued in Europe covering the management of grown-up congenital heart disease (GUCH).

More than two million adults in Europe are deemed to be affected by the condition, and the numbers are growing as a consequence of sharply increased survival rates due to advances in pediatric cardiology and heart surgery. The new guidelines, issued by the European Society of Cardiology (ESC; Sophia Antipolis, France), enhance and update the recommendations contained in an earlier version issued in 2003, and were presented at the ESC Congress in Stockholm, Sweden, on August 29, 2010.

GUCH is a condition that requires a complicated and challenging management regime. The chair of the Task Force responsible for drafting and issuing the guidelines is Prof. Helmut Baumgartner of University Hospital (Muenster, Germany). He has a great deal of experience in the treatment and care of patients with GUCH, and is a former chair of the ESC Working Group that is focused on that condition. Prof. Baumgartner stated, "The document describes the many ongoing problems encountered in adults with congenital heart disease. These patients frequently face great difficulties as adults in the management of their condition, and what we expect to achieve with these guidelines is a series of detailed recommendations that will help improve their quality of life."

The new guidelines build on the knowledge gained when compiling the 2003 version. Since randomized, controlled trials are the exception in this field, its recommendations are primarily based on expert consensus, observational studies, and registries. It expands previously tabulated content into a full and detailed description of the 18 most common subsets of the condition, detailing the most effective management for each, including the use of echocardiography, computer tomography (CT), magnetic resonance (MR), catheterization and other diagnostic techniques; decision-making on the timing of surgical or catheter intervention and reintervention; and lastly, ongoing monitoring and medical treatments.

Successful management of GUCH requires a multidisciplinary approach. As well as drawing in experts in the condition itself and in general cardiology, the Task Force was represented by the Association for European Pediatric Cardiology (AEPC) and the following ESC entities: Associations: European Association for Percutaneous Cardiovascular Interventions (EAPCI), European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and the European Association of Echocardiography (EAE); Councils: Cardiology Practice, Council on Primary Care, Cardiovascular Imaging, and Cardiovascular Nursing and Allied Professions; Working Groups: Grown-up Congenital Heart Disease, Pulmonary Circulation and Right Ventricle Function, Valvular Heart Disease, Cardiovascular Surgery, Thrombosis, and Acute Cardiac Care

Related Links:
European Society of Cardiology