
Contents
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Introduction Introduction
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Patients with ACHD may present to CICU in three circumstances: Patients with ACHD may present to CICU in three circumstances:
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Postoperatively following cardiac intervention Postoperatively following cardiac intervention
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Postoperatively following non-cardiac surgery Postoperatively following non-cardiac surgery
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Management of medical emergency Management of medical emergency
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Predictors of ICU outcome in ACHD Predictors of ICU outcome in ACHD
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General considerations General considerations
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Arrhythmias Arrhythmias
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Cyanosis Cyanosis
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Haemoptysis Haemoptysis
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Heart failure Heart failure
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General principles in care of patients with ACHD General principles in care of patients with ACHD
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Further reading Further reading
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Lesion-specific considerations Lesion-specific considerations
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Tetralogy of Fallot Tetralogy of Fallot
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Transposition of the great arteries—Mustard or Senning repair Transposition of the great arteries—Mustard or Senning repair
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Transposition of the great arteries—switch repair Transposition of the great arteries—switch repair
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Congenitally corrected transposition of the great arteries Congenitally corrected transposition of the great arteries
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Fontan and TCPC circulations Fontan and TCPC circulations
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Conclusion Conclusion
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Further reading Further reading
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19 The adult patient with congenital heart disease
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Published:March 2014
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Abstract
This chapter describes the role of the cardiac intensive care unit (CICU) in the management of adult patients with congenital heart disease (ACHD). This is a growing population as possibly 90% of infants with congenital heart disease now survive to adulthood. Patients with ACHD may present to CICU in three circumstances: postoperatively following cardiac intervention, postoperatively following non-cardiac surgery, and during the management of a medical emergency. Specialist expertise on the physiological consequences of the abnormal cardiac anatomy can optimize the CICU outcome. The chapter presents a glossary and description of common congenital syndromes and descriptors. It goes on to consider management of key problems including arrhythmias, cyanosis, haemoptysis, and heart failure. It outlines the general principles of care in patients with ACHD and discusses the implications of some important specific conditions: tetralogy of Fallot, transposition of the great arteries, and the Fontan circulation.
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