Emory/Sibley Adult Congenital Cardiac Center: Only Specialized Center in the State For Diagnosing And Treating Adults Who Were Born with Heart Defects

Emory University
Monday, 3 November 2003

The Emory/Sibley Adult Congenital Cardiac Center is one of only a few medical centers in the U.S -- and the only one in Georgia -- specializing in the diagnosis and treatment of adults with congenital heart disease (CHD). It is a specialty, however, that is increasingly needed as the medical community is faced with what has been called an impending "flood" of adults with CHD.

Surgical advances developed over the past several decades have saved the lives of countless children born with heart defects. That means that thousands of people who, in earlier times, would never have lived past their childhood or teen years are now reaching young adulthood. In fact, according to the Adult Congenital Heart Association (ACHA), there are currently about 750,000 adults with CHD in the United States -- and the majority need on-going specialized care.

"As they grow older, these people can experience often complex medical problems as a result of both congenital cardiac malformations and/or complications from pediatric repairs. And as adults, they often face issues such as pregnancy, employment and acquired illnesses more suitable to an adult medical setting. However, the complexities of their congenital cardiac defects and the sequelae of prior 'reparative' surgeries many of them have undergone are best understood by pediatric cardiologists who have extensive training in this area," says Michael E. McConnell, MD, a pediatric cardiologist at Children's Healthcare of Atlanta and Co-Director of the Emory/Sibley Adult Congenital Cardiac Center.

"That's why it's important for them to be seen by specialists who can put all these factors together. We've found that a combined management team including both adult and pediatric cardiologists, echocardiographers, interventional cardiologists and electrophysiologists provides the multidisciplinary approach needed to diagnose and best care for this group of patients."

Emory Heart Center cardiologist Wendy Book , MD, Co-Director of The Emory/Sibley Adult Congenital Cardiac Center and a specialist in heart failure and heart transplants, points out that sometimes health problems from CHD can come as a surprise to patients and their doctors who may have believed a congenital problem was solved by childhood surgeries.

"It is not unusual for a patient to believe a heart defect was permanently 'fixed' in childhood, only to find out that is not the case when problems develop later in life," Dr. Book says. "Fortunately many of these problems can be treated with medication and dietary modifications. Occasionally, cardiac catheterization and/or surgery is necessary. Because patients may be unaware of a problem, consultation prior to considering pregnancy is extremely important to ensure that mother and baby have the best possible outcome."

She explains that patients seen at The Emory/Sibley Adult Congenital Cardiac Center present with a broad range of problems: "These include uncorrected defects, the development of new lesions superimposed on an early repair, newly recognized congenital heart defects, complex arrhythmias, and pregnancy issues. Adolescents with CHD sometimes develop 'adult' acquired cardiac problems such as atherosclerotic heart disease, heart attack or heart failure."

Just as surgical innovations helped initially to save the lives of people born with heart defects, medical and therapeutic advances are now helping adult patients with CHD who receive specialized care to live the healthiest lives possible. "Electrophysiology studies can be used to map arrhythmias and many can be cured with radiofrequency ablation. Catheter-based interventions have also gained an important place in the treatment of congenital heart defects and can often be used to close holes in the heart called atrial septal defects ( ASDs), for example," says Dr. Book.

Douglas Morris, MD, Director of the Emory Heart Center, points out that Emory has a long history of innovation in caring for people with CHD.

"For example, Charles Hatcher, MD performed Georgia's first 'blue baby' open heart procedure in l962 at Emory to correct a tetralogy of Fallot - a serious abnormality characterized by four related heart defects," says Dr. Morris. "Today, Emory is in the forefront of treating the growing number of adult cardiac patients with congenital heart problems. The Emory/Sibley Adult Congenital Cardiac Center serves a very important need by providing this population with centralized care by specialists skilled in treating these often complicated and highly individual cardiac problems."

For more information, or to contact Emory University, see their website at: whsc.emory.edu