ESC releases new Clinical Practice Guidelines for management of Grown-up Congenital Heart Disease

Sep 2 2010

The European Society of Cardiology (ESC) today announces the release of new Clinical Practice Guidelines covering the management of Grown-up Congenital Heart Disease (GUCH). More than two million adults in Europe are assumed to be affected by the condition, and the numbers are growing as a consequence of sharply increased survival rates due to advances in paediatric cardiology and heart surgery. The new guidelines enhance and update the recommendations contained in an earlier version issued in 2003, and will be presented at the ESC Congress in Stockholm on 29 August during the Clinical Practice Guidelines session in lecture room Stockholm, Zone K, starting at 0910hrs.

GUCH is a condition that requires a complex and demanding management regime.  The Chair of the Task Force responsible for drafting and issuing the guidelines is Professor Helmut Baumgartner of University Hospital, Muenster in Germany.  He has a great deal of experience in the treatment and care of patients with GUCH, and is a former Chair of the ESC Working Group that is focused on that condition. Professor Baumgartner says, "The document describes the many ongoing problems encountered in adults with congenital heart disease. These patients frequently face great difficulties as adults in the management of their condition, and what we expect to achieve with these guidelines is a series of detailed recommendations that will help improve their quality of life."

The new guidelines build on the knowledge gained when compiling the 2003 version. Since randomised controlled trials are the exception in this field, its recommendations are mainly based on expert consensus, observational studies and registries. It expands previously tabulated content into a full and detailed description of the 18 most common sub-sets of the condition, detailing the most effective management for each, including:

• The use of echocardiography, computer topography (CT), magnetic resonance (MR), catheterisation and other diagnostic techniques
• Decision-making on the timing of surgical or catheter intervention and re-intervention
• Ongoing monitoring and medical treatments

Successful management of GUCH requires a multi-disciplinary approach. As well as drawing in experts in the condition itself and in general cardiology, the Task Force was represented by the Association for European Paediatric Cardiology (AEPC) and the following ESC entities:

• Associations: European Association for Percutaneous Cardiovascular Interventions (EAPCI), European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and the European Association of Echocardiography (EAE)
• Councils: Cardiology Practice, Council on Primary Care, Cardiovascular Imaging, and Cardiovascular Nursing and Allied Professions
• Working Groups: Grown-up Congenital Heart Disease, Pulmonary Circulation and Right Ventricle Function, Valvular Heart Disease, Cardiovascular Surgery, Thrombosis, and Acute Cardiac Care

Professor Baumgartner is pleased to have led the Task Force that developed the new guidelines. "These patients are very demanding, and there is no doubt that there are a wide range of special needs in their care and treatment," he says. "We do hope that this document can help to improve the quality of GUCH care."