An increasing number of children with congenital heart disease are surviving into adulthood due to greatly improved surgical, medical, anaesthetic and intensive care over the last few decades. The survival of congenital patients into adulthood is now close to 85% in comparison to the 15% survival rate several decades ago. This new group of patients is now entering adulthood and will need regular monitoring and sometimes further surgical interventions may also be required.
With the exception of a few conditions, ligation of isolated
patent ductus arteriosus (PDA) and closure of isolated
atrial septal defects (ASD) and
ventricular septal defects (VSD), surgical treatment of congenital heart disease is more often palliative than curative. Repeated procedures and interventions are the norms as conduits, baffles, shunts and grafts become stenosed, blocked and incompetent with time. In addition to the medical and surgical issues, this growing population may also face specific social, psychological and behavioral problems throughout their life.
It is timely that adult congenital heart disease (ACHD) (also known as congenital heart disease in adults) is gaining recognition worldwide and in Singapore as an established subspecialty of cardiology.
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