When a child is born with an abnormally formed heart, it is classified as congenital heart disease. Congenital heart disease is a life-long condition that affects patients throughout childhood and into adulthood. The USC Adult Congenital Heart Disease Center at Keck Medicine of USC provides complete clinical and surgical care to patients born with heart defects. Given advances in medical and surgical care, patients with congenital heart disease are expected to survive to adulthood. In fact, there are currently more adults living with congenital heart disease than there are children. It is critically important that these patients continue care with a specialized team that has specific expertise in adult congenital heart disease.
The center’s specialists are experts in pediatric and adult cardiology and cardiothoracic surgery. Specialist teams are formed and designed to provide the most comprehensive cardiac care possible for patients living with congenital heart disease. Our staff partners with an extensive network of specialists at Keck Medicine of USC to connect adult congenital heart disease patients with providers who specialize in managing other conditions unique to these patients.
The Adult Congenital Heart Disease Center has developed a multidisciplinary approach that delivers optimal care tailored to each patient’s unique case. Our approach incorporates all facets of care and has been designed to help patients with complex congenital cardiac conditions. This entails:
- Comprehensive outpatient and inpatient services
- Collaboration between surgeons and cardiologists with expertise in diagnostic, interventional and surgical services unique to adults with congenital heart disease
- Partnership with the USC network of specialists to ensure complete treatment of non-cardiac medical conditions
A unique affiliation with Children’s Hospital Los Angeles (CHLA) allows us to provide young adults with congenital heart disease who require ongoing medical care with a seamless transition to our adult care setting. We have a monthly transitional clinic at CHLA where we see teenagers and young adults who are approaching 21 years of age. During their transition clinic visit, patients are introduced to our team and prepared for successful transition to Keck Medical Center of USC. Early preparation and education about the long-term management of the patient’s condition can empower them to stand with their doctors in managing their medical condition.
Abnormal Heart Valves
A variety of congenital and acquired heart defects can result in dysfunction of the heart valves. These valves may be malformed or undergo progressive changes with time that result in improper opening and closing, leading to obstruction and/or leakage of blood flow. Learn more about Valve Repair and Replacement.
Aortic Dissection is a tear in the wall of the aorta, the artery carrying blood out of the heart.
A significant percentage of adult congenital heart disease patients are at risk of developing arrhythmias, or abnormal heart rhythms. The risk increases with age and the duration of follow-up care.
Atrial Septal Defect
An atrial septal defect is a hole within the atrial septum or the wall that normally separates the left and right atrial chambers of the heart. A defect in the atrial septum permits blood to pass between the left and right sides of the heart. This results in an increased amount of blood that passes through and must be handled by the right side of the heart and the lungs.
Atrioventricular Canal Defect
An atrioventricular canal defect is a combination of related defects of the heart, which leads to a large defect in the heart’s center. Atrioventricular canal defect includes an atrial septal defect, ventricular septal defect and abnormalities in the heart’s valves.
Coarctation of the Aorta
Coarctation of the aorta is the narrowing of the aorta, which makes it difficult for the artery to supply the body with blood.
Progressive heart failure develops in some adult patients with unrepaired or palliated congenital heart disease. Heart transplantation is offered and managed by our experienced treatment team. Learn more about the Center for Advanced Heart Failure.
Pulmonary hypertension, high blood pressure in the arteries of the lungs, may develop in some adult patients with unrepaired or palliated congenital heart disease. Learn more about the Center for Vascular Care.
A single ventricle defect occurs when a child is born with only one ventricle that is strong enough to pump blood out of the heart.
Tetralogy of Fallot
Tetralogy of Fallot is a congenital heart disease, in which four heart abnormalities are present. They are ventricular septal defect, narrowing of the pulmonary valve;, an overriding aorta and a thickened muscle surround the right ventricle. This defect limits oxygen rich blood flow sometimes causing blue-tinged skin in infants.
Transposition of Great Arteries (TGA)
Transposition of Great Arteries is a congenital heart condition in which the aorta and pulmonary artery are switched. Normally, blood enters the heart from the body on the right side and through the pulmonary artery to the lungs. Then, blood leaves the lungs through the left side of the heart and through the aorta to the body. In TGA, blood that travels through the lungs enters the heart and is returned to the lungs. Blood that enters the heart from the body is sent back to the body without oxygen.
Ventricular Septal Defect
A ventricular septal defect is a hole within the wall that normally separates the left and right ventricles.
The USC Adult Congenital Heart Disease Center offers patients comprehensive diagnostic facilities with state-of-the-art radiology and cardiac imaging centers and a wide range of minimally invasive surgical and non-surgical treatment options, including percutaneous valve replacements, transcatheter ablations of arrhythmias and a full range of implantable cardiac rhythm devices.
Specific treatments include:
Novel interventions for adults with congenital heart disease
Catheter-based interventions are often used to address issues in adult congenital heart patients. Among these are balloon dilation and stent implantation as therapies for vessel and valve stenosis; device-based closure of fenestrations or baffle leaks; percutaneous valve implantation and hybrid procedures that combine surgical and technological expertise to resolve specific needs.
Single Ventricle and Fontan patients
Patients born with one instead of two ventricles now live to adulthood as a result of a staged palliative surgical approach that culminates with the Fontan procedure. Owing to modifications to this procedure over the last few decades, there are adult single-ventricle patients living with various forms and types of the Fontan connection. A comprehensive and multidisciplinary approach to the care of Fontan patients is essential to ensure the maintenance of good ventricular function, the prevention or treatment of arrhythmias and the maximization of functional capacity. When necessary, interventional catherization, invasive electrophysiologic, and surgical procedures can be employed to address conditions that may arise in the adult Fontan patient.
Pacemakers and Implantable Defibrillators
Patients with congenital heart disease frequently experience arrhythmias or abnormalities in heart rhythm. Slow arrhythmias can be addressed with implantation of a pacemaker. Rapid arrhythmias can also be addressed with pacemakers and dangerously fast arrhythmias are managed, in part, by implantation of an ICD.
The Ross procedure is a surgical procedure used to address obstructions to blood flow from the left ventricle to the aorta and functional problems with the aortic valve. The patient’s diseased aortic valve is replaced with his or her own pulmonary valve.
American Heart Association – Congenital Heart Defects
Adult Congenital Heart Association
International Society for Adult Congenital Heart Disease
Children’s Heart Foundation
Children’s Hospital Los Angeles – Heart Institute