Right Ventricular Assessment by Real-time Three-dimensional Echocardiography in Congenital Heart Disease

The remarkable improvement in survival of patients with congenital heart disease has led to a growing number of adult patients. In particular, patients with more complex disease showed favorable outcomes in the last decades. In addition, some defects (e.g. atrial septal defect, Ebstein’s anomaly, and congenitally corrected transposition of the great arteries) may be diagnosed for the first time in adult life. A wide range of birth prevalence estimates has been reported, and therefore complicates the evaluation of the number of patients with congenital heart disease. In the Netherlands, every year approximately 1400 children are born with a congenital heart defect. At present, it is estimated that there are over 40.000 adults with congenital heart disease and this group is annually growing with ~5%. Besides, there are about 25.000 children with a congenital heart defect. The 32nd Bethesda Conference report in 20006 estimated that there were ~2800 adults with congenital heart disease per 1 million population in the United States, with more than half of them having moderate or high complexity of their defect. The reported birth prevalence of congenital heart disease varied from four to fifty per 1000 live births. The prognosis of patients with congenital heart disease has increased over the last decades, because of improved surgical techniques and pediatric care. Now that operative mortality of the early repair has fallen to low levels, attention has turned to improvement of longer-term outcomes and preservation of cardiac function.

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