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Predicting survival in adults with congenital heart disease: what are the odds?
  1. Jonathan Buber1,
  2. Anne Marie Valente2,3,4
  1. 1Division of Cardiology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
  2. 2Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts, USA
  3. 3Division of Cardiology, Department of Internal Medicine, Brigham & Women’s Hospital, Boston, Massachusetts, USA
  4. 4Faculty of Internal Medicine and Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Anne Marie Valente, Department of Cardiology, Boston Children’s Hospital, Boston, MA 02115, USA; anne.valente{at}cardio.chboston.org

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The constantly growing rates of survival to adulthood among individuals born with congenital heart disease (CHD) is one of modern medicine’s greatest triumphs. Over the past several years, substantially greater survival rates of patients with CHD have been reported by groups from all around the world, and it is currently expected that over 90% of those born with CHD will reach adulthood.

Thus, it appears that the field of CHD gradually joins other fields in Cardiology, such as advanced heart failure and valvular heart disease, in which vast advancement in treatment options and patient survival have been achieved. Similar to those fields, the focus of CHD-related epidemiological research has been progressively turning towards more accurate evaluation of survival trajectories and identification of populations of patients who may be at a greater risk of mortality and morbidity burdens.

However, even the most meticulously performed survival studies, which typically require large cohorts of patients, numerous years of follow-up and rigorous analysis, may bear paramount shortcomings that limit their applicability to a wide spectrum of patients. Designing and executing large survival analyses that focus on patients with CHD can prove to be an even more challenging task, given the heterogeneity of this population. Close scrutiny of the results of several of the larger CHD-based survival analyses published over the past several years, which are also …

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