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This article focuses on a study that analyzes employment outcome in adults with congenital heart disease (CUD). The aim of the study was to compare employment rates in adults with CHD with controls, the general population, and at different seventies of CHD. Adults with CHD are significantly more likely to be unemployed than both matched controls and the general population. They also have a high rate of lone term unemployment. Education of patients and employers as to the capabilities and limitations expected of an individual with CHD may improve their employment outcome.

This article focuses on a study related to maternal outcome of pregnancy following mustard procedure. Mustard procedure was performed between 1966 and the early 1990s for infants with transposition of the great arteries. Many of these patients are now of child bearing age. Pregnancy is extremely high risk for women in NYHA2 or worse following Mustard procedure. Asymptomatic women with good cardiac function tolerate pregnancy well. The natural history of gradual deterioration in cardiac function in many patients following Mustard procedure suggests that earlier pregnancy should be advised.

OBJECTIVES: To develop a modified technique for stenting the atrial septum in the treatment of patients with a failing Fontan operation or pulmonary hypertension. SETTING: Two tertiary referral centres. STUDY DESIGN: Prospective collaborative clinical study. PATIENTS AND METHODS: A stent was mounted on a standard valvoplasty balloon catheter which was constricted to a predefined diameter by a loop created from a temporary pacing wire. Full balloon inflation created a diabolo shaped stent configuration. The technique was employed in 12 consecutive patients to relieve symptoms of a failing Fontan circulation (n = 6) or severe pulmonary hypertension (n = 6). RESULTS: Ex vivo studies confirmed that a diabolo shaped stent configuration could be achieved using the above technique. Transcatheter stent implantation was successful in all 12 patients. All six Fontan patients showed significant clinical improvement. Right atrial pressure decreased from (mean (SD)) 16.8 (2.5) to 13.7 (1.9) mm Hg (p < 0.05), and arterial oxygen saturation from 92.8 (1.8)% to 82.7 (3.8)% (p < 0.01). Six patients underwent successful stent fenestration for treatment of pulmonary hypertension. All stents were patent and stable at the most recent follow up (mean 1.75 (1.05) years). No early or late stent related complications were encountered. CONCLUSIONS: This new technique allows placement of a diabolo shaped stent with a predefined diameter across the atrial septum. The diabolo shape increases stent stability, facilitates recrossing of the stent during future catheter interventions, and ensures medium term stent patency. [ABSTRACT FROM AUTHOR]