Background
A major barrier for adult congenital heart disease (ACHD) services in developing countries is the insufficient data on the disease burden and specific needs of this population. Our goal was to the clinical profile and challenges of ACHD patients in Egypt who require further surgical correction.
Methods
The study comprised ACHD patients (above 14 years of age) scheduled for further surgical correction following a heart team discussion at a tertiary cardiac center in Egypt. Data on age, gender, presentation, functional capacity, resting oxygen saturation, diagnosis, previous intervention and its timing, and the type of planned surgery were collected.
Results
Throughout one year, 103 cases (49.5% males, mean age 23 years) were referred to surgery out of 134 cases discussed by the heart team. One-third (34%) were cyanotic. The majority presented in NYHA class II (44.7%) and III (35.95%) and had a previous surgical or trans-catheter intervention (56.3%) at a median age of four years. The most frequent diagnoses were Tetralogy of Fallot (ToF) (23.3%), atrial septal defect (ASD) (18.4%), double outlet right ventricle (11.6%), and transposition of great arteries (7.8%). The most common planned surgical procedures were Fontan (20.3%), ASD closure (18.4%), pulmonary valve replacement (14.5%), total ToF repair (9.7%), subaortic membrane resection (6.7%) and tricuspid valve surgery (5.8%).
Conclusion
ACHD patients in our database who require additional surgical correction are heterogeneous, with highly variable presentations and surgical complexity. An efficient ACHD program mandates a multidisciplinary team that is familiar with this patient population's unique demands and difficulties.