Preparing Adults with Congenital Heart Disease for Surgery or Intervention

  • Lynda ShaughnessyEmail author
  • Rafael Alonso-Gonzalez
Part of the Congenital Heart Disease in Adolescents and Adults book series (CHDAA)


ACHD patients can be challenging to comprehensively manage as they require a multidisciplinary team approach with specialists working in collaboration in many areas. As the number of patients surviving with severe congenital heart disease increases, so does the complexity of the care required and the number of specialist practitioners involved with this patient group. It is necessary to be prepared for what may occur with any intervention with ACHD patients. The medical team needs to be prepared as well as the patient. This chapter aims to address some of the specific areas that need to be prepared in order for adults with congenital heart disease to be cared for at the highest levels and minimizing the morbidities that occur with complex interventions.


Adult with congenital heart disease Cardiac surgery Anesthesia Multidisciplinary Psychology Multi-organ Palliative 


  1. 1.
    Allan C. Intensive care of the adult patient with congenital heart disease. Prog Cardiovasc Dis. 2011;53:274–80.CrossRefGoogle Scholar
  2. 2.
    Marelli A, Mackie A, Ionescu-Ittu R, Rahme E, Pilote L. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation. 2007;115:163–72.CrossRefGoogle Scholar
  3. 3.
    Somerville J. Report of the British Cardiac Society Working Party. Grown-up congenital heart (GUCH) disease: current needs and provision of service for adolescents and adults with congenital heart disease in the UK. Heart. 2002;88(Suppl 1):1–14.Google Scholar
  4. 4.
    Dearani J, Connolly H, Martinez R, Fontanet H, Webb G. Caring for adults with congenital heart disease: successes and challenges for 2007 and beyond. Cardiol Young. 2007;17(Suppl 4):87–96.PubMedGoogle Scholar
  5. 5.
    Verheugt C, Uiterwaal C, van der Velde E, Mejiboom F, Pieper F, Sieswerda G, Plokker H, Grobbee D, Mulder B. The emerging burden of hospital admissions of adults with congenital heart disease. Heart. 2010;96(11):872–8.CrossRefGoogle Scholar
  6. 6.
    Mackie A, Pilote L, Ionescu-Ittu R, Rahme E, Marelli A. Health care resource utilisation in adults with congenital heart disease. Am J Cardiol. 2007;99(6):839–43.CrossRefGoogle Scholar
  7. 7.
    Asiliogu K, Celik S. The effect of pre-operative education on anxiety of open cardiac surgery patients. Patient Educ Couns. 2002;53:65–70.CrossRefGoogle Scholar
  8. 8.
    Viney C. Pain and sedation needs. Cited in: Nursing the critically ill. London: Bailliere Tindall; 1996.Google Scholar
  9. 9.
    Quinn S, Redmond K, Begley C. The needs of relatives visiting the adult intensive care units as perceived by relatives and nurses. Intensive Crit Care Nurs. 1996;12(3):168–72.CrossRefGoogle Scholar
  10. 10.
    McGonigal K. The importance of sleep and the sensory environment to critically ill patients. Intensive Care Nurs. 1986;2(2):73–83.CrossRefGoogle Scholar
  11. 11.
    Garbee D, Gentry A. Coping with the stress of surgery. AORN J. 2001;73:946–51.CrossRefGoogle Scholar
  12. 12.
    Watts S. Patients’ perceptions of the pre-operative information they need about events they may experience in the intensive care unit. J Adv Nurs. 1997;26:85–92.CrossRefGoogle Scholar
  13. 13.
    Nelson S. Pre-admission education for patients undergoing cardiac surgery. Br J Nurs. 1996;5:335–40.CrossRefGoogle Scholar
  14. 14.
    Wit P, Duivervoorden H, Dixhoorn J. More psychological preparation in heart surgery for certain patients is beneficial. Ned Tijdschr Geneeskd. 1996;140:1720–3.PubMedGoogle Scholar
  15. 15.
    Hathaway D. Effect of preoperative instruction on postoperative outcomes: a meta-analysis. Nurs Res. 1986;35:269–75.CrossRefGoogle Scholar
  16. 16.
    Egbert L, Batit G, Welch C, Bartlett M. Reduction of post-operative pain by encouragement and instruction of patients. N Engl J Med. 1964;270:825–7.CrossRefGoogle Scholar
  17. 17.
    Janis I. Psychological stress: psychoanalytical and behavioural studies of surgical patients. New York: Wiley; 1958.CrossRefGoogle Scholar
  18. 18.
    Johnston M, Vögele C. Benefits of psychological preparation for surgery: a meta-analysis. Ann Behav Med. 1993;15(4):245–56.Google Scholar
  19. 19.
    Bysshe J. The effect of giving information to patients before surgery. Nursing. 1988;3(30):36–9.PubMedGoogle Scholar
  20. 20.
    Mott A. Psychologic preparation to decrease the anxiety associated with cardiac catheterisation. J Vasc Nurs. 1999;17:41–9.CrossRefGoogle Scholar
  21. 21.
    Wicker P. Pre-operative visiting: making it work. Br J Theatr Nurs. 1995;5(7):16–9.Google Scholar
  22. 22.
    Webb R. Pre-operative visiting from the perspective of the theatre nurse. Br J Theatr Nurs. 1995;4(16):919–25.CrossRefGoogle Scholar
  23. 23.
    Boore J, Champion R, Ferguson C, editors. Nursing the physically ill adult. Edinburgh: Churchill Livingstone; 1987.Google Scholar
  24. 24.
    Gillies M, Baldwin G. Do patients booklets increase preoperative anxiety. Eur J Anaesthesiol. 2001;18:620–2.CrossRefGoogle Scholar
  25. 25.
    Brown M, Joseph D, Burkhart H. The adult with congenital heart disease: medical and surgical considerations for management. Curr Opin Pediatr. 2009;21:561–4.CrossRefGoogle Scholar
  26. 26.
    Alonso-Gonzalez R, Borgia F, Diller G, Inuzuka R, Kempny A, Martinez-Naharro A, Tutarel O, Marino P, Wustmann K, Charalambides M, Silva M, Swan L, Dimopoulos K, Gatzoulis M. Abnormal lung function in adults with congenital heart disease: prevalence, relation to cardiac anatomy, and association with survival. Circulation. 2013;127(8):882–90.CrossRefGoogle Scholar
  27. 27.
    O’Donohue W Jr. Postoperative pulmonary complications. When are preventive and therapeutic measures necessary? Postgrad Med. 1992;91:167.CrossRefGoogle Scholar
  28. 28.
    Giannakoulas G, Dimopoulos K, Engel R, Goktekin O, Kucukdurmaz Z, Vatankulu M, Bedard E, Diller G, Papaphylactou M, Di Francis D, Mario C, Gatzoulis M. Burden of coronary artery disease in adults with congenital heart disease and its relation to congenital and traditional heart risk factors. Am J Cardiol. 2009;103(10):1445–50.CrossRefGoogle Scholar
  29. 29.
    Bokma J, Zegstroo I, Kuijpers J, Konings T, van Kimmenade R, van Melle J, Kiès P, Mulder B, Bouma B. Factors associated with coronary artery disease and stroke in adults with congenital heart disease. Heart. 2018;104(7):574–80.CrossRefGoogle Scholar
  30. 30.
    Nishimura A, Otto C, Bonow R, Carabello B, Erwin J 3rd, Guyton R, O'Gara P, Ruiz C, Skubas N, Sorajja P, Sundt T 3rd, Thomas J. American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(22):2438–88.CrossRefGoogle Scholar
  31. 31.
    Thalji N, Suri R, Daly R, Greason K, Dearani J, Stulak J, Joyce L, Burkhart H, Pochettino A, Li Z, Frye R, Schaff H. The prognostic impact of concomitant coronary artery bypass grafting during aortic valve surgery: implications for revascularization in the transcatheter era. J Thorac Cardiovasc Surg. 2015;149(2):451–60.CrossRefGoogle Scholar
  32. 32.
    Janson C, Shah M. Supraventricular tachycardia in adult with congenital heart disease: mechanisms, diagnosis and clinical aspects. Card Electrophysiol Clin. 2017;9:189–211.CrossRefGoogle Scholar
  33. 33.
    Karangelis D, Mazine A, Narsupalli S, Medis S, Veldtman G, Nikolaidis N. Morbidity after cardiac surgery in patient with adult congenital heart disease in comparison with acquire heart disease. Heart Lung Circ. 2018;27(6):739–44.CrossRefGoogle Scholar
  34. 34.
    Gatzoulis M, Balaji S, Webber S, Siu S, Hokanson J, Poile C, Rosenthal M, Nakazawa M, Moller J, Gillette P, Webb G, Redington A. Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot: a multicentre study. Lancet. 2000;356(9234):975–81.CrossRefGoogle Scholar
  35. 35.
    Avila P, Chaix M, Mondésert B, Khairy P. Sudden cardiac death in adult congenital heart disease. Card Electrophysiol Clin. 2017;9:225–34.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Adult Congenital Heart Disease UnitRoyal Brompton HospitalLondonUK

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