Date of Award
Restricted Access Thesis
MS in Physician Assistant Studies (PA)
Physician Assistant Studies
Dr. Vanessa Bester, EdD, MPAS, PA-C
Background: Recent advancements in medicine have allowed those with Congenital Heart Disease (CHD) to live beyond childhood. The rising numbers of Adults with Congenital Heart Disease (ACHD) has been followed by increased Congestive Heart Failure (CHF) numbers in these patients, therefore necessitating research for the management of these patients. This research paper reviews articles analyzing ACHD management, both non-surgically and surgically, in those who develop CHF.
Methods: A literature review was conducted to evaluate the non-surgical versus surgical practices for treatment of heart failure (HF) in adults with congenital heart disease (ACHD).
Discussion: Both non-surgical and surgical management strategies for heart failure (HF) in adults with congenital heart disease (ACHD) come with limitations. Pharmacologic therapies traditionally utilized in HF have limited studies verifying efficacy and harm reduction to the ACHD population such as angiotensin converting enzyme inhibitors (ACE inhibitors) and -blockers. Planned surgical reconstructions constitute necessary treatments in many types of CHD and require strict follow-up and support of the patient. Heart transplantation constitutes the last options for therapeutic management of ACHD, however challenges regarding placement on the transplant list require superior classification strategies instead of exclusion criteria.
Conclusion: Traditional HF therapy may be inconclusive in helping ACHD patients, but not excluded as therapy. Innovative approaches are necessary to explore new pharmacologic options that may extend the pre-transplant life of the ACHD heart and requires close monitoring and communication between patient and provider.
LaCroix, Miranda, "Non-Surgical vs. Surgical Management of Heart Failure in Adults with Congenital Heart Disease" (2020). Theses and Graduate Projects. 1057.