Preventing cardiovascular complications in adults with congenital heart disease: predictors and outcomes of the levels of follow-up care - Scorecard - MDSpire

Preventing cardiovascular complications in adults with congenital heart disease: predictors and outcomes of the levels of follow-up care

  • By

  • Fouke Ombelet

  • Ruben Willems

  • Steffen Fieuws

  • Eva Goossens

  • Katya De Groote

  • Werner Budts

  • Stéphane Moniotte

  • Michèle de Hosson

  • Liesbet Van Bulck

  • Julie De Backer

  • Lieven Annemans

  • Ariane Marelli

  • Philip Moons

  • BELCODAC consortium

  • Lieven Annemans

  • Werner Budts

  • Julie De Backer

  • Katya De Groote

  • Michèle de Hosson

  • Daniel De Wolf

  • Marc Gewillig

  • Eva Goossens

  • Chris Leyman

  • Stéphane Moniotte

  • Philip Moons

  • Fouke Ombelet

  • Agnes Pasquet

  • Thierry Sluysmans

  • Liesbet Van Bulck

  • Alexander Van De Bruaene

  • Ruben Willems

  • December 16, 2025

  • 0 min

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Clinical Scorecard: Mitigating Cardiovascular Risks in Adults with Congenital Heart Disease: Factors Influencing Follow-Up Care and Associated Outcomes

At a Glance

CategoryDetail
ConditionAdult Congenital Heart Disease (ACHD)
Key MechanismsFollow-up care levels (specialized ACHD care, non-specialized ACHD cardiac care, no cardiac follow-up) influence clinical outcomes including heart failure, myocardial ischaemia, thromboembolic events
Target PopulationAdults living with congenital heart disease in Belgium
Care SettingSpecialized ACHD centers, general cardiologists, non-cardiac care providers

Key Highlights

  • Only 19% of patient-years involved specialized ACHD care; even among complex defects, only 52% received specialized follow-up.
  • Regular cardiac follow-up, especially in specialized ACHD centers, reduces risk of heart failure, myocardial ischaemia, and thromboembolic events.
  • Male sex, genetic syndrome, and no prior intervention predict higher levels of follow-up care.

Guideline-Based Recommendations

Diagnosis

  • Allocate ACHD patients to levels of care based on anatomical complexity and physiological status per 2018 AHA/ACC guidelines.

Management

  • Provide follow-up care in specialized ACHD centers or by general cardiologists according to patient complexity.
  • Ensure continuous cardiac follow-up to reduce risk of heart failure, myocardial ischaemia, and thromboembolic events.

Monitoring & Follow-up

  • Monitor patients regularly in specialized or non-specialized ACHD cardiac care to detect and manage complications early.

Risks

  • Lack of cardiac follow-up is associated with increased risk of heart failure, myocardial ischaemia, and thromboembolic events.

Patient & Prescribing Data

Adults with congenital heart disease across three Belgian university hospitals

Specialized ACHD follow-up is protective against heart failure and myocardial ischaemia; any cardiac follow-up reduces myocardial ischaemia and thromboembolic events.

Clinical Best Practices

  • Prioritize referral of ACHD patients, especially those with complex defects, to specialized ACHD centers for follow-up.
  • Maintain continuous cardiac follow-up to improve clinical outcomes and reduce major cardiovascular events.
  • Use patient characteristics such as sex, genetic syndromes, and intervention history to identify those needing higher levels of follow-up care.

References

Original Source(s)

Preventing cardiovascular complications in adults with congenital heart disease: predictors and outcomes of the levels of follow-up care

  • by Fouke Ombelet, Ruben Willems, Steffen Fieuws, Eva Goossens, Katya De Groote, Werner Budts, Stéphane Moniotte, Michèle de Hosson, Liesbet Van Bulck, Julie De Backer, Lieven Annemans, Ariane Marelli, Philip Moons, BELCODAC consortium, Lieven Annemans, Werner Budts, Julie De Backer, Katya De Groote, Michèle de Hosson, Daniel De Wolf, Marc Gewillig, Eva Goossens, Chris Leyman, Stéphane Moniotte, Philip Moons, Fouke Ombelet, Agnes Pasquet, Thierry Sluysmans, Liesbet Van Bulck, Alexander Van De Bruaene, Ruben Willems

  • December 16, 2025

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