Usefulness of stroke volume monitoring during upright ramp incremental cycle exercise in young patients with Fontan circulation.

Background: Aerobic capacity (VO2 max) of patients with Fontan circulation (FC) is lowest within patients with congenital heart disease. The reasons have not been completely elucidated.

Methods: Twenty five young patients with non-failing FC underwent a cardiopulmonary test during an upright ramp cycling.

Pregnancy outcomes in patients with pulmonary arterial hypertension associated with congenital heart disease.

Objective: There is growing evidence that maternal mortality in pregnant women with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) is lower than that in available data. In order to evaluate this hypothesis, we collected data of pregnancies in women with PAH-CHD.

Methods: Women with PAH-CHD followed in seven French referral centres were retrospectively included from 1997 to 2015.

Longitudinal strain of systemic right ventricle correlates with exercise capacity in adult with transposition of the great arteries after atrial switch.

Background: Systemic right ventricle (sRV) dysfunction in d-transposition of the great arteries following atrial switch (d-TGA) is associated with increased mortality. We aimed to characterize maladaptive sRV mechanisms in d-TGA patients, analyzing relation of echocardiographic parameters of sRV systolic function to objective measurements of exercise capacity.

Methods: Forty-seven adult patients with d-TGA and atrial switch (mean age 31.

Usefulness of maximal oxygen pulse in timing of pulmonary valve replacement in patients with isolated pulmonary regurgitation.

Patients with pulmonary regurgitation after tetralogy of Fallot repair have impaired aerobic capacity; one of the reasons is the decreasing global ventricular performance at exercise, reflected by decreasing peak oxygen pulse. The aims of our study were to evaluate the impact of pulmonary valve replacement on peak oxygen pulse in a population with pure pulmonary regurgitation and with different degrees of right ventricular dilatation and to determine the predictors of peak oxygen pulse after pulmonary valve replacement. The mean and median age at pulmonary valve replacement was 27 years.

Maternal and fetal outcomes of pregnancy with Fontan circulation: A multicentric observational study.

Background: Despite serious long-term sequel, women with Fontan palliation have reached childbearing age. However there is paucity of data on the pregnancy outcomes and management of this condition. We aimed to determine the maternal and fetal outcomes of pregnancy in women with Fontan palliation.

Novel method of surgical preparation for transcatheter completion of Fontan circulation: creation of an extracardiac pathway.

Background: The alliance between surgeons and interventionists has inspired creative techniques to surgically precondition the heart for subsequent transcatheter repair. The interest stems from the need to avoid repeated surgeries. Transcatheter Fontan completion of intracardiac pathway has been reported.

Key issues of daily life in adults with congenital heart disease.

Increasing survival rates of patients with congenital heart disease have resulted in a new and growing patient population of adults with operated congenital heart disease. Medical professionals face the specific medical needs of these patients but must also deal with their daily life issues. Adult patients with congenital heart disease report difficulties in several areas of daily life, such as sport, employment, insurability and travel or driving.

[Contraception and congenital heart disease].

Contraception counselling should be an integral part of any adolescent or adult congenital heart disease program. Both the cardiovascular safety and contraceptive efficacy of each contraceptive method should be considered for each cardiac condition. The method recommended should combine acceptability to the woman with the highest efficacy and safety profile.

[What congenital heart diseases may cause problems in adulthood?].

The number of patients with congenital heart disease exceeds now the number of children born with these defects. This is related to the "success story" of cardiac surgery and interventional catheterism. The prevalence of this new population is about 3-4 patients/1000 adults in the general population.

Optimal follow-up in adult patients with congenital heart disease and chronic pulmonary regurgitation: towards tailored use of cardiac magnetic resonance imaging.

Background: Pulmonary regurgitation (PR) is a common complication of right ventricular outflow tract (RVOT) reconstruction and leads to right ventricular (RV) dilatation and dysfunction. Although cardiac magnetic resonance (CMR) is the gold standard for evaluating PR and RV dysfunction, cost and limited availability are problems in many centres.

Aims: To determine clinical, electrocardiographic and echocardiographic predictors of these complications and optimize patient selection for their short-term follow-up by CMR.

[Preventing complications of cardiac malformations in poor countries].

Natural selection and therapeutic efficiency limit the type of cardiac malformations that/can be treated in poor countries. Most of the patients studied here are those with left-to-right shunts (arterial, atrial and, especially, ventricular), right-to-left shunts associated with a ventricular septal defect (tetralogy of Fallot) or an atrial septal defect (trilogy of Fallot), and stenosis of the pulmonary or aortic valves. Early diagnosis is crucial, but this will require a new health policy involving specially trained nurses or technicians equipped with cheap portable echo-Doppler machines to examine babies' hearts.