Children Who Survive Congenital Heart Disease Still Face Increased Mortality Risks Interview with:
Zacharias Mandalenakis MD, PhD

Internist, Cardiologist
GUCH-centrum, Cardiology section,
Emergency, Geriatric & Internal Medicine Department
Sahlgrenska University Hospital
Gothenburg, Sweden What is the background for this study? What are the main findings?

Response: According to our national registry data in Sweden, the survivorship in children and young adults with congenital heart disease has been increased the last decades in Sweden; Although, the overall mortality risk has decreased by more than 100 times compared to controls,children with congenital heart disease younger than 5 years and born in the beginning of 1990’s still have a mortality risk more than 33 times higher than matched controls from the general population. What should readers take away from your report?

Response: Our study results shows that the pediatric and adult care has been improved in Sweden also as in the western countries the last decades.

Although, young patients with congenital heart disease is still a vulnerable group of patients and due to increasing survivorship the risk of acquired diseases is also increased. Despite that the risk of mortality has been decreased, the relative risk in relation to people of similar age and gender, is much higher. So physicians must be aware that any patient presenting with a history of congenital heart disease, is at increased risk of having a complication of their congenital condition. A bit of reverse thinking is applied when you discuss this with a patient with a congenital heart condition: the outlook for him/her has much improved and the absolute risk of having a severe complication, is very low. What recommendations do you have for future research as a result of this study?

Response: Further research on reducing the death rate in this vulnerable group of patients is required. Can meticulous care of conventional risk factors for cardiovascular disease, i.e. blood pressure, glucose metabolism, physical activity and cholesterol, decrease the risk for patients with congenital heart disease, should they be focus for special interest and special care in order to avoid these complications, if they can indeed be avoided ? Is there anything else you would like to add?

Response: What makes our study so special? It is a large, national cohort, with a large number of controls, covering 25 years of evolution and from a country with national, well covering high quality registers and centralized, public health care available for everyone. Thank you for your contribution to the community.


JAMA publication:

JAMA Intern Med 2016 Dec 19. Epub 2016 Dec 19.

Zacharias Mandalenakis, Annika Rosengren, Kristofer Skoglund, Georgios Lappas, Peter Eriksson, Mikael Dellborg

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on January 2, 2017 by Marie Benz MD FAAD