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Adult Congenital Heart Disease: Latest Advances and Prospects
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Adult Congenital Heart Disease: Latest Advances and Prospects

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 30 July 2025 | Viewed by 4331

Special Issue Editor

Prof. Dr. Agata Bielecka-Dabrowa

E-Mail Website
Guest Editor
1. Department of Cardiology and Congenital Heart Diseases of Adults, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), 93-338 Lodz, Poland
2. Department of Preventive Cardiology and Lipidology, Medical University of Lodz, Lodz, Poland
Interests: heart failure; body mass compartments; sarcopenia; obesity; echocardiography; congenital heart diseases; cardiovascular diseases in pregnancy; hypertension
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Improvements in the diagnosis and surgical treatment of congenital heart disease (CHD) during infancy and childhood have resulted in an outstanding increase in the prevalence of these entities during adulthood. Cardiologists and imagers frequently encounter complex patients who have undergone multiple prior operations and interventions. Consequently, there has been a parallel increase in the number of ACHD patients plagued with heart failure. Late morbidity can be related to the congenital heart defects but may also be the consequence of surgical or medical treatment or longstanding alterations in hemodynamics, neurodevelopment and psychosocial development. Advanced imaging plays a role in diagnosis and preprocedural planning, and it also determines the need and frequency of follow-up. As such, we have planned this Special Issue of JCM, as adults with CHD require not only close monitoring and proactive personalized management strategies to improve outcomes but also implementation of new therapeutic options.

Submissions of original articles and reviews that are useful for readers and their subsequent daily clinical practices are welcome.

Prof. Dr. Agata Bielecka-Dabrowa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • adult congenital heart disease
  • heart failure
  • Fontan circulation
  • Tetralogy of Fallot
  • cathetherisation and structural interventions

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Published Papers (3 papers)

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Research

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17 pages, 308 KiB  
Article
Impact of the COVID-19 Pandemic on the Everyday Life and Healthcare of Patients with Congenital Heart Defects: Insights from Pandemic Onset to One Year Later
by Emily Schütte, Saskia Olivia Nasri, Anna-Lena Ehmann, Janina Semmler, Felix Berger, Ulrike M. M. Bauer, Katharina Schmitt, Cornelia Tremblay, Julia Remmele, Stefan Orwat, Gerhard-Paul Diller, Constanze Pfitzer and Paul C. Helm
J. Clin. Med. 2025, 14(10), 3462; https://doi.org/10.3390/jcm14103462 - 15 May 2025
Viewed by 87
Abstract
Background/Objectives: The COVID-19 pandemic impacted healthcare access globally, with chronic conditions like congenital heart defects (CHD) posing unique challenges. While general trends have been studied, little is known about the impact on CHD patients in Europe. This study assessed the living conditions, healthcare [...] Read more.
Background/Objectives: The COVID-19 pandemic impacted healthcare access globally, with chronic conditions like congenital heart defects (CHD) posing unique challenges. While general trends have been studied, little is known about the impact on CHD patients in Europe. This study assessed the living conditions, healthcare utilization, and psychosocial well-being of CHD patients and their families in Germany, considering CHD severity, gender differences, and changes over time. Methods: Data were derived from two cross-sectional online surveys conducted by the National Register for Congenital Heart Defects (NRCHD) in April 2020 and April 2021. Surveys targeted CHD patients and relatives, assessing healthcare access, risk perception, COVID-19-related knowledge, and psychosocial effects. Statistical analyses compared responses by gender, CHD severity, and survey period. Results: A total of 6737 responses were analyzed. Healthcare utilization declined early in the pandemic due to infection fears but partially recovered in 2021. Perceived health risks increased from 27.9% in 2020 to 38.7% in 2021 (p < 0.001), along with higher psychosocial distress. COVID-19-related knowledge was greater in 2020, but trust in government information declined, while reliance on healthcare providers increased. Gender and CHD severity influenced healthcare engagement and perceptions. Conclusions: This study highlights the challenges CHD patients faced, underscoring the need for holistic, patient-centered care. Future interventions should focus on tailored communication and support strategies, particularly for vulnerable populations, to mitigate the impact of future health crises. Full article
(This article belongs to the Special Issue Adult Congenital Heart Disease: Latest Advances and Prospects)
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12 pages, 1026 KiB  
Article
Efficacy and Safety of Percutaneous ASD Closure in Adults: Comparative Outcomes of Occluder Devices in a Single-Center Cohort
by Elham Kayvanpour, Elena Matzeit, Christoph Reich, Ziya Kaya, Sven Pleger, Norbert Frey, Benjamin Meder and Farbod Sedaghat-Hamedani
J. Clin. Med. 2025, 14(6), 1867; https://doi.org/10.3390/jcm14061867 - 10 Mar 2025
Viewed by 611
Abstract
Background: Atrial septal defect (ASD) is a prevalent congenital heart condition, resulting in left-to-right shunting. Untreated ASDs may be associated with complications, including right-sided heart failure, pulmonary hypertension, and atrial arrhythmias. Percutaneous ASD closure, performed with various occluder devices, has become the preferred [...] Read more.
Background: Atrial septal defect (ASD) is a prevalent congenital heart condition, resulting in left-to-right shunting. Untreated ASDs may be associated with complications, including right-sided heart failure, pulmonary hypertension, and atrial arrhythmias. Percutaneous ASD closure, performed with various occluder devices, has become the preferred approach for symptomatic patients with suitable anatomy, yet data on device-specific efficacy and safety profiles remain limited. Methods: This study was a retrospective, single-center analysis involving patients who underwent percutaneous ASD closure between January 2000 and February 2023. Data on patient characteristics, indications for the procedure, procedural details, and clinical outcomes were extracted from electronic medical records. Endpoints included complications at the puncture site, pericardial effusion, atrial arrhythmias, device-related thrombus formation, and overall survival. Results: A total of 195 patients were included (mean age 53.6 ± 16.2 years; 60.5% female). Three different devices were used: Amplatzer ASD occluder (n = 111), Gore Septal Occluder (n = 67), and Occlutech ASD occluder (n = 17). Initial procedural success rate was 90.8%, with no significant differences observed between devices. Periprocedural complication rates were low and comparable across all devices. New-onset atrial fibrillation within the first month post-implantation occurred in 7.5% of patients with the Gore device, compared to 0.9% with the Amplatzer device (p = 0.03) and 0% with the Occlutech device. No statistically significant differences were observed among the devices regarding thrombus formation, late-onset pericardial effusion, device erosion, or stroke. Conclusions: Percutaneous ASD closure demonstrates high procedural success and low complication rates across different occluder devices, supporting its efficacy and safety as a treatment for adults. Although the Gore device showed a higher incidence of new-onset AF compared to the Amplatzer device, no significant differences were observed regarding thrombus formation, pericardial effusion, device erosion or stroke. Full article
(This article belongs to the Special Issue Adult Congenital Heart Disease: Latest Advances and Prospects)
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Review

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34 pages, 998 KiB  
Review
Blood Biomarkers as a Non-Invasive Method for the Assessment of the State of the Fontan Circulation
by Andrzej Wittczak, Anna Mazurek-Kula, Maciej Banach, Grzegorz Piotrowski and Agata Bielecka-Dabrowa
J. Clin. Med. 2025, 14(2), 496; https://doi.org/10.3390/jcm14020496 - 14 Jan 2025
Viewed by 2960
Abstract
The Fontan operation has become the primary palliative treatment for patients with a functionally univentricular heart. The population of patients with Fontan circulation is constantly growing and aging. As the number of Fontan patients surviving into adulthood increases, there is a clear need [...] Read more.
The Fontan operation has become the primary palliative treatment for patients with a functionally univentricular heart. The population of patients with Fontan circulation is constantly growing and aging. As the number of Fontan patients surviving into adulthood increases, there is a clear need for research on how best to follow these patients and manage their complications. Monitoring blood biomarkers is a promising method for the non-invasive assessment of the Fontan circulation. In this article, we provide a comprehensive review of the available evidence on this topic. The following biomarkers were included: natriuretic peptides, red blood cell distribution width (RDW), cystatin C, high-sensitivity C-reactive protein, vitamin D, parathyroid hormone, von Willebrand factor, carbohydrate antigen 125, lipoproteins, hepatocyte growth factor, troponins, ST2 protein, galectin-3, adrenomedullin, endothelin-1, components of the renin–angiotensin–aldosterone system, norepinephrine, interleukin 6, tumor necrosis factor α, and uric acid. We did not find strong enough data to propose evidence-based recommendations. Nevertheless, significantly elevated levels of brain natriuretic peptide (BNP)/N-terminal prohormone of BNP (NT-proBNP) are most likely associated with the failure of the Fontan circulation. The use of the RDW is also promising. Several biomarkers appear to be useful in certain clinical presentations. Certainly, robust longitudinal, preferably multicenter, prospective studies are needed to determine the sensitivity, specificity, evidence-based cut-off values and overall predictive value of different biomarkers in monitoring Fontan physiology. Full article
(This article belongs to the Special Issue Adult Congenital Heart Disease: Latest Advances and Prospects)
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