TY - JOUR
T1 - Thromboembolic complications in adult congenital heart disease: the knowns and the unknowns
AU - Karsenty, Clément
AU - Waldmann, Victor
AU - Mulder, Barbara
AU - Hascoet, S. bastien
AU - Ladouceur, Magalie
N1 - Funding Information: Dr S?gol?ne Claeyssens, Pr Philippe Acar Publisher Copyright: © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2021/9
Y1 - 2021/9
N2 - Abstract: Despite impressive improvement in long-term survival, adults with congenital heart disease (CHD) remain exposed to a significant cardiovascular morbidity over lifetime. Thromboembolic events (TE) are a major issue. Specific anatomic groups have been shown a particular high risk of TE, including cyanotic heart disease and Fontan circulation. Many intercurrent clinical factors add a substantial risk such as intracardiac medical devices, atrial arrhythmia, endocarditis, or pregnancy. Nevertheless, what is unknown exceeds what is known, especially regarding the management of this heterogenous patient population. Anticoagulation decision should always be individualized weighing balanced with the alternative risk of hemorrhagic complications. In this review, we aim to synthetize existing literature on TE in adults with CHD, discuss management issues, highlight gaps in knowledge, and intend to suggest high priority research. Graphical Abstract: [Figure not available: see fulltext.]
AB - Abstract: Despite impressive improvement in long-term survival, adults with congenital heart disease (CHD) remain exposed to a significant cardiovascular morbidity over lifetime. Thromboembolic events (TE) are a major issue. Specific anatomic groups have been shown a particular high risk of TE, including cyanotic heart disease and Fontan circulation. Many intercurrent clinical factors add a substantial risk such as intracardiac medical devices, atrial arrhythmia, endocarditis, or pregnancy. Nevertheless, what is unknown exceeds what is known, especially regarding the management of this heterogenous patient population. Anticoagulation decision should always be individualized weighing balanced with the alternative risk of hemorrhagic complications. In this review, we aim to synthetize existing literature on TE in adults with CHD, discuss management issues, highlight gaps in knowledge, and intend to suggest high priority research. Graphical Abstract: [Figure not available: see fulltext.]
KW - Congenital heart disease
KW - Management
KW - Stroke
KW - Thromboembolic events
UR - http://www.scopus.com/inward/record.url?scp=85092372627&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00392-020-01746-2
DO - https://doi.org/10.1007/s00392-020-01746-2
M3 - Review article
C2 - 33037501
SN - 1861-0684
VL - 110
SP - 1380
EP - 1391
JO - Clinical research in cardiology
JF - Clinical research in cardiology
IS - 9
ER -