Epidemiological study of congenital heart disease in patients attending outpatient clinics

AIM:To evaluate the relative incidence, the proportion and the complications of congenital heart disease (CHD) in patients attending outpatient clinics. METHODS: A cohort of 11,780 patients diagnosed as having CHD consisting of 26 types of cardiac lesions was registered from January 2005 to January 2011. The proportion of the 26 types of cardiac lesions, the relative incidence and proportion of 8 common lesions, including atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA), tetralogy of Fallot (ToF), pulmonic stenosis (PS), atrioventricular septal defect (AVSD), aortic valve stenosis (AS) and transposition of great arteries (TGA), in infants, children and adults, and the characteristics of three complications, including pulmonary hypertension, atrial fibrillation and infectious endocarditis in patients with VSD, ASD, PDA or AS were analyzed. RESULTS: The proportions of VSD (53.8% vs. 26.6%; P<0.01), ToF (8.6% vs. 2.5%; P<0.01) and TGA (5.1% vs. 0.2%; P<0.01) in children were significantly higher than those in adults, while the proportions of ASD (5.7% vs. 41.1%; P<0.01) and AS (0.4% vs. 6.8%; P<0.01) in children were significantly lower than those in adults. Eisenmenger syndrome was the commonest complication that contraindicated surgery. Of patients with VSD, ASD and PDA, 97% of them contraindicated surgery because of associated Eisenmenger syndrome. Only 10% of the patients with Eisenmenger syndrome survived 50 years. The incidence of atrial fibrillation was 2.4% in ASD, 1.1% in PDA and 0.2% in VSD population. The incidence of infective endocarditis was 6.1% in AS, 0.55% in PDA and 0.52% in VSD population. CONCLUSIONS: The prevalence and the survival rate of CHD patients vary with cardiac lesions and ages. Cardiac intervention in infants and children may prevent disability and complications that affect the life quality of the patients.