Transition and transfer from pediatric to adult care of the young adult with complex congenital heart disease.

This article focuses first on the process of transition and transfer of care of young adults with complex congenital heart disease. It defines the transition process and briefly discusses its history. It reviews the important aspects of transition, outlines the key elements of a successful transition program, and provides a curriculum appropriate for the young adult with congenital heart disease.

Transcatheter device closure of congenital and postoperative residual ventricular septal defects.

Background: Our purpose was to describe a 13-year experience with patients undergoing transcatheter device closure of unrepaired congenital or postoperative residual ventricular septal defects (VSDs).

Methods And Results: Since 1989, 170 patients (median age, 3.9 years) have undergone catheterization for closure of 1 or more congenital (n=92) or postoperative (n=78) residual VSDs using successive generations of STARFlex-type devices.

Respiratory symptoms secondary to aortopulmonary collateral vessels in tetralogy of Fallot absent pulmonary valve syndrome.

Hemodynamically significant systemic-to-pulmonary artery collaterals may represent an underappreciated cause of cardiorespiratory compromise in tetralogy of Fallot with absent pulmonary valve (TOF/APV). We retrospectively reviewed the angiographic, magnetic resonance imaging, operative, and autopsy reports of the 50 patients with TOF/APV managed at our institution in the past 10 years and demonstrated that at least 7 of 50 patients (14%) had significant aortopulmonary collaterals.

Interatrial communication through the mouth of the coronary sinus.

Objectives: We describe the structure of, and suggest an etiology for, the interatrial communication which can occur through the mouth of the coronary sinus. Based on the study of human embryos, we propose that the defect is best explained by dissolution of the wall of the coronary sinus adjacent to the left atrium, permitting shunting between the atriums through the right atrial orifice of the sinus.

Background: An interatrial communication across the mouth of the coronary sinus defect was first described in 1965 by Raghib and colleagues, its existence being predicated on the basis of incomplete formation of the left "atriovenous fold".