The grown-up congenital cardiac patient

The diagnosis and successful management of congenital heart disease represents one of the greatest triumphs of cardiovascular medicine and surgery in the 20th century. As a consequence, the number of adults with congenital heart disease – both with repaired and unrepaired lesions – has grown rapidly, and is now approaching one million in North America. Similar increases have occurred in Western Europe. The care of adults with congenital heart disease represents a major challenge. They include a large number of diverse anatomic malformations of varying severities at various stages of their natural history and with different degrees of anatomic repair. Approximately one-third of these patients are considered to have ‘simple’ congenital heart disease, such as mild pulmonic stenosis or repaired ventricular septal defect. The majority, however, such as those with cyanotic congenital heart disease, have lesions of greater complexity. The growing population of adults with congenital heart disease presents unique problems in management. Arrhythmias are frequent and are often of serious import. Pregnancy presents special problems. The risk of infective endocarditis and premature ventricular dysfunction may occur in patients even following successful correction. There is a delicate interplay between managing the usual risks for the development of coronary artery disease in adults and the residua of repaired congenital heart disease, such as coarctation of the aorta. During the past two decades the approach to the diagnosis and treatment of adults with congenital heart disease has been totally transformed.

Prof. Tsvetomir Loukanov, MD, PhD



The grown-up congenital cardiac patient

Prof. Snezhana Tisheva, MD, PhD, DSc



Etiology, Epidemiology and Classification of Adult Patients with Congenital Heart

Prof. Maria Tzekova, MD, PhD



Congenital heart diseases – clinical presentation, diagnosis and treatment.

Assoc. prof. Pencho Kratunkov, MD, PhD



Invasive Diagnostics and Interventional Treatment of Grown-up Congenital Heart Diseases