Congenital heart disease

Congenital heart disease occurs in 8 per 1,000 live births, the most common lesions are ventricular septal defects (>30%). Cyanotic lesions are less common, with Fallot’s Tetralogy and transposition of the great arteries accounting for 10% or less of all congenital lesions. Genetic causes of congenital heart disease are well recognized and include chromosomal defects such as Down’s syndrome and single gene lesions such as Noonan syndrome. Microdeletions such as that on chromosome 22 q11 are also associated with congenital heart disease. Many lesions can be treated with interventional cardiac catheterization, recently ventricular septal defects have been closed with a transcatheter device. Transcatheter closure of atrial septal defects is now the treatment of choice. Cardiac surgery for complex lesions has improved and there is now a low mortality for correction of transposition. Surgical treatment for hypoplastic left heart is now offered in many centres, and results have improved although the long term outcome is uncertain because of late ventricular failure. The complex surgical repairs such as total cavo-pulmonary connection are likely to provide an increasing burden on adult cardiology services.