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Aims Since knowledge about the psychosocial function of adult patients with congenital heart disease is limited, we compared biographical characteristics, and emotional and social functioning of these patients with that of the reference groups.Methods and results Patients with congenital heart disease (\batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \(N=362\) \end{document}, aged 20–46 years), belonging to five diagnostic groups, were subjected to extensive medical and psychological examination, 20–33 years after their first open heart surgery. All the patients were seen by the same psychologist, who examined their psychosocial functioning using a structured interview and questionnaires. The majority (78%)was living independently and showed favourable outcome regarding the marital status. Among married/cohabitant patients, 25–39-year-olds showed normal offspring rates. None of the 20–24-year-old patients had any children. The offspring rate dropped after the age of 40. The proportion of adult patients with a history of special education was high (27%). Accordingly, patients showed lower educational and occupational levels compared to reference groups. As regard to the emotional and social functioning (leisure-time activities), the sample showed favourable results.Conclusions Overall, this sample of patients with congenital heart disease seemed capable of leading normal lives and seemed motivated to make good use of their abilities. [ABSTRACT FROM PUBLISHER]

Aims Although studies have suggested good long-term results, arrhythmias, pulmonary hypertension and left ventricular dysfunction are mentioned as sequelae long-term after surgical atrial septal defect closure at young age. Most studies were performed only by questionnaire and in a retrospective manner. The long-term outcome is very important with regard to future employment and acceptance on insurance schemes.Methods and Results One hundred and thirty-five consecutive ASD-patients, operated on in childhood, were studied longitudinally with ECG, echocardiography, exercise testing and Holter-recording 15 (10–22) and 26 (21–33) years after surgery. During follow-up no cardiovascular mortality, stroke, heart failure and no pulmonary hypertension occurred. Symptomatic supraventricular tachyarrhythmias were present in 6% after 15 years, and an additional 2% occurred in the last decade; 5% needed pacemaker implantation. No relation was found between arrhythmias and type of ASD, baseline data, right ventricular dimensions, or age at operation. Left and right ventricular function and dimension remained unchanged. Slightly more patients had right atrial dilatation at last follow-up. Exercise capacity was comparable with the normal Dutch population.Conclusions The long-term outcome after ASD closure at young age shows excellent survival and low morbidity. The incidence of supraventricular arrhythmias is lower than in natural history studies of ASD patients and also lower than after surgical correction at adult age. [ABSTRACT FROM PUBLISHER]

In 38 consecutive patients the pulmonary autograft was used in aortic root replacement. Investigations were performed with transthoracic echocardiography, trans-oesophageal echocardiography and magnetic resonance imaging in 31, 27 and 27 patients respectively. The mean age at operation was 28·7 years (range 19·0–52·0) and the follow-up period was 2·8 years (range 0·8–6·7). The pul-monary autograft diameter was measured at the subannular region (1), at the annulus at the hinge points of the valve leaflets (2), at the sinus (3), at the sino-tubular junction (4) and at the distal part of the autograft (5). With trans-oesophageal echocardiography the mean systolic measurements at levels 1 to 5 were 32, 31, 42, 35 and 34mm, respectively. The corresponding diastolic measurements were smaller: 25, 28, 42, 35 and 34mm respectively. There was no significant difference between transthoracic echo-cardiography and transoesophageal echocardiography measurements of the proximal autograft (levels 1–3). Diameters obtained with magnetic resonance imaging were 1 to 3mm larger than those obtained with transthoracic echocardiography and transoesophageal echocardiography (P<0·05), except the annulus at systole (P>0·3).ConclusionsThe mean pulmonary autograft diameters measured using transthoracic echocardiography, transoesophageal echocardiography and magnetic resonance imaging were larger than native aortic and pulmonary diameters of a normal population in the same age group. Diameters of the distal 2 levels could not be imaged reliably with transthoracic echocardiography. Magnetic resonance imaging diameter measurements were, in general, larger than with echocardiography. [ABSTRACT FROM PUBLISHER]