Prevalence of congenital heart disease - 26/08/11

Doi : 10.1016/j.ahj.2003.05.003

Julien I.E Hoffman, MD, FACC ^a,^b,^⁎ , Samuel Kaplan, MD, FACC ^c, Richard R Liberthson, MD, FACC ^d
^a Department of Pediatrics, University of California, San Francisco, Calif, USA
^b Cardiovascular Research Institute, University of California, San Francisco, Calif, USA
^c Ahmanson/UCLA Adult Congenital Heart Disease Center, Departments of Medicine, Pediatrics, and Surgery, UCLA School of Medicine, Los Angeles, Calif, USA
^d Department of Medicine, Massachusetts General Hospital, Boston, Mass, USA

^*Reprint requests: Julien I. E. Hoffman, MD, FACC, Box 0544, Room M1331, University of California, 505 Parnassus Avenue, San Francisco, CA 94143, USA.

Abstract

Background

Today most patients with congenital heart disease survive childhood to be cared for by adult cardiologists. The number of physicians that should be trained to manage these lesions is unknown because we do not know the number of patients.

Methods

To answer this question, the expected numbers of infants with each major type of congenital heart defect born in each 5-year period since 1940 were estimated from birth rates and incidence. The numbers expected to survive with or without treatment were estimated from data on natural history and the results of treatment. Finally, lesions were categorized as simple, moderate, or complex, based on the amount of expertise in management needed for optimal patient care.

Results

From 1940 to 2002, about 1 million patients with simple lesions, and half that number each with moderate and complex lesions, were born in the United States. If all were treated, there would be 750,000 survivors with simple lesions, 400,000 with moderate lesions, and 180,000 with complex lesions; in addition, there would be 3,000,000 subjects alive with bicuspid aortic valves. Without treatment, the survival in each group would be 400,000, 220,000, and 30,000, respectively. The actual numbers surviving will be between these 2 sets of estimates.

Conclusions

Survival of patients with congenital heart disease, treated or untreated, is expected to produce large numbers of adults with congenital disease, and it is likely that many more adult cardiologists will need to be trained to manage moderate and complex congenital lesions.

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