Cardiac Biomarkers in Adult Congenital Heart Disease

Abstract

Congenital heart disease (ConHD) is the most common congenital abnormality in newborns, with a birth prevalence of 9 per 1000 live births.2 ConHD comprises a number of cardiac abnormalities with varying aetiology which can be divided into simple, moderate and complex disease (Table 1). The eight most common ConHD are ventricular septal defect (34%), atrial septal defect (13%), persistent ductus arteriosus (10%), pulmonary stenosis (8%), tetralogy of Fallot (ToF, 5%), aortic coarctation (5%), transposition of the great arteries (TGA, 5%) and aortic stenosis (4%). With the introduction of open-heart surgery, and the use of cardiopulmonary bypass (heart-lung machine) life expectancy of ConHD patients has remarkably improved. Before these techniques became available half of the new-borns with ConHD died during the first decade of life. Improvements over the last decades in cardiac surgery, anaesthesia, intensive care and specialized congenital cardiologist care have led to a steadily growing number of adult patients with ConHD, in particular those patients with more complex ConHD. The estimated number of adults with ConHD in the Netherlands is 35.000 currently.