Jassim M Abdulhamed Senior Senior Co C nsultant o nsultant P a P ediatric ediatric Card Car iology

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1 Jassim M Abdulhamed Senior Consultant Paediatric Cardiology

2 Accomplishment Advances in diagnostic methods and in the surgical and medical care of infants and children with congenital heart disease,over the last years, have resulted in one of the most successful rehabilitation programs that medicine has witnessed. More than 90% of children with CHD who survived infancy will live to at least 15 years. Nat Clin. prac. Cardiovascular medicine Jan 2006 vol3 No 1

3 Prevalence There are currently over 250,oo0 in the UK Approximately 1,000,000 in the USA Similar numbers in Europe & other parts of the world 1000, , ,000

4 Prevalence It will continue to grow as more patients survive early interventions and adult patients with heart disease live longer. The population of adult with ih congenital heart disease is estimated to be increasing at a rate of about 5% per year. The New England journal of medicine Jan. 27 2ooo

5 HOWEVER Most early interventions have not been curative. The group also includes patients who have never undergone surgery and those who are inoperable apart from organ transplant. 50% ACHD patients face the prospect of further surgery, arrhythmia, heart failure and if managed inappropriately of premature death. The increasing workload of caring of this group of patients is therefore both quantitative and qualitative. Int. J card 96:

6 The initiate i i Specialized multidisciplinary facilities for the comprehensive care of adult with congenital heart disease were begun: Toronto General Hospital Royal Brompton Hospital Circulation vol.84, No 5 November 1991

7 Expanding care of ACHD

8 Expanding care of ACHD Country Specialized Non specialized Netherland 5 5 Spain 4 3 Poland 5 1 Belgium Bli 4 1 Sweden 4 Germany 3 2 U K 3 1 Greece 2 1 Switzerland 2 1 Egypt 1 1 France 1 Italy l 1

9 History 19 October TOTAL TOF 312 Mustard 145 Arch 26 AVSD 74 Fontan 16 Shunt 439

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11 ADULT WITH CONGENITAL HEART DISEASE

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13 History 18/12/2002

14 Adult Congenital Heart Disease, PSCC : 2003 Adult Congenital Heart Disease Out patient clinic started Dr. Najashi in training, Toronto General Hospital, Canada.

15 Adult Congenital Heart Disease, PSCC : 26 ربيع األول 1430

16 TOTAL OF BEDs 3 male 3 Female TOTAL OF ADMISSIONs 15/2/2011 / 700 AGE RANGE 12 years 65 years

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18 Supporting Services Imaging Electrophysiology Catheter lab. Heart fil failure ACHD Pulmonology Obstetric Gynecology Social worker Psychology

19 Future Plans Increase bed capacity to 10 beds. Instillation i of MRI unit. A dedicated Surgeon to deal with adult patient with congenital heart disease. Increase out patient sessions to 4 /week. Dedicated database system for Adult With Congenital Heart Disease.

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21 Adult Congenital Heart Disease: PSCC : Entry may begin at age of 12 years, recognizing ii adolescent medicine as a bridge between the pre adolescent patient and adult. Circulation vol. 84, No 5 November 1991.

22 PSCC Univentricular Heart Symposium Marriott Hotel, Riyadh 4 5 October 2011

23 Series 3 Series 2 Series 1 Series 2 Series 3 Category 1 Category 2 Category 3 Category 4 Series 1