Epidemiology of adult congenital heart disease, including pulmonary hypertension and infective endocarditis

摘要

Considerable progress has been made over the past three decades in the surgical treatment of congenital heart disease, changing the epidemiology of this subspecialty. Thus, the prevalence of adults with congenital heart disease has greatly increased, almost doubling, and has now reached the rate of 3 to 4 per 100,000 inhabitants in industrialized countries, where exhaustive data are available. Whereas congenital heart disease was often fatal in children, increasingly these individuals are dying during adulthood, and complex congenital heart defects are now as frequent in adults as in children. Complex congenital heart defects represent approximately 10% of the population of adults with a congenital heart defect. Pulmonary hypertension and infective endocarditis are two major comorbidities associated with congenital heart disease; although little studied, their epidemiology has also changed. In Europe, there are estimated to be approximately 1.2 to 2.9 million patients with congenital heart defects aged more than 15 years. Extrapolation from the most relevant epidemiological studies to France, where no registry is available, results in a prevalence of 210,000 adults with congenital heart disease, of whom more than 20,000 have a complex form. Adults with congenital heart defects therefore present a new population for whom each healthcare system must optimize their care.