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Cardiovasc Diagn Ther. 2018 Dec;8(6):716-724. doi: 10.21037/cdt.2018.10.16.

Improving medical care and prevention in adults with congenital heart disease-reflections on a global problem-part II: infective endocarditis, pulmonary hypertension, pulmonary arterial hypertension and aortopathy.

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Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany.
Department of Cardiology, Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan.
Dokuz Eylul University Hospital air Esref Cad, İzmir, Turkey.
Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Toronto General Hospital, University of Toronto, Toronto, CA, Canada.
Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, USA.
Central Clinical School Heart Research Institute C39 - Royal Prince Alfred Hospital, The University of Sydney, NSW, Australia.
Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Munich, Germany.
Behavioral Epidemiology, Institute for Clinical Psychology und Psychotherapy, Technical University Dresden, Dresden, Germany.
Preventive Pediatrics, Technical University Munich, Munich, Germany.
Cardiological Clinic Solingen, Solingen, Germany.
Department of Cardiac Surgery, University of Erlangen, Erlangen, Germany.
Department of Cardiology, University of Erlangen, Erlangen, Germany.
Clinic for Thorax-, Heart- and Vessel Surgery, German Heart Competence Center, Tübingen, Germany.
Medical Clinic I, University Mannheim, Mannheim, Germany.
University Heart Center Hamburg, University Clinic Hamburg-Eppendorf, Hamburg, Germany.
Clinic for Pediatric Cardiology und Intensive medicine, Medical School Hannover, Hannover, Germany.
Institute for Clinical Pharmacology, Medical Faculty, Technical University Carl Gustav Carus, Dresden, Germany.
Competence Network Congenital Heart Defects, Berlin, Germany.


Despite relevant residua and sequels, follow-up care of adults with congenital heart disease (ACHD) is too often not performed by/in specialized and/or certified physicians or centers although major problems in the long-term course may develop. The most relevant encompass heart failure, cardiac arrhythmias, heart valve disorders, pulmonary vascular disease, infective endocarditis (IE), aortopathy and non-cardiac comorbidities. The present publication emphasizes current data on IE, pulmonary and pulmonary arterial hypertension and aortopathy in ACHD and underlines the deep need of an experienced follow-up care by specialized and/or certified physicians or centers, as treatment regimens from acquired heart disease can not be necessarily transmitted to CHD. Moreover, the need of primary and secondary medical prevention becomes increasingly important in order to reduce the burden of disease as well as the socioeconomic burden and costs in this particular patient group.


Congenital heart defect (CHD); aortopathy; endocarditis; heart failure; prevention; primary health care; pulmonary hypertension

Conflict of interest statement

Conflicts of Interest: R Neidenbach received research grants (“Unrestricted educational grant”) from Actelion Pharmaceuticals Deutschland GmbH and from the German Heart Foundation (“Deutsche Herzstiftung e.V.”) and the patient organization “Herzkind e. V.”; H Kaemmerer received fees and/or travel expenses for consulting activities and/or lectures from the following companies within the last 3 years: Actelion, Pfizer, Bayer-Healthcare, Bristol-Myers Squibb; D Pittrow has received speaker fees or honoraria for consultations from Actelion, Bayer, Genzyme, Boehringer Ingelheim, Novartis, MSD. and Dr. Erwin Oechslin currently holds the “Bitove Family Professorship for Adult Congenital Heart Disease”. Other author have no conflicts of interest to declare.

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