Adult Congenital Heart Disease. Chapter 17

Improvements in both medical and surgical care in patients with congenital heart disease have resulted in increased longevity and, therefore, an increased prevalence of adults with congenital heart disease [17.1]. As more such patients survive into adulthood, the development of the subspecialty of adult congenital heart disease (ACHD) has increased in significance. The majority of ACHD patients have undergone surgical repairs in childhood, and lifelong follow‑up is recommended. Many patients with ACHD do not recognize subtle changes in exercise capacity, and serial imaging is important to monitor them for haemodynamic and anatomical sequelae. Despite advances in the management of ACHD patients, their mortality is still seven times higher than comparable peers without such conditions, and disease progression in intervened and non‑intervened individuals into adulthood is a major factor to be considered. The need for non‑invasive imaging of these patients both for diagnostic, management and prognostic purposes has led to significant developments in cardiac imaging to cater for this unique group of patients.