On our cover this month, eight-year-old Bikram Thapa shows off the scar on his chest after undergoing surgery to repair a congenital heart defect at the Carolinas Medical Center in Charlotte, North Carolina. Bikram, a refugee from Bhutan, has struggled to breathe since birth.
Many children like Bikram have undergone surgery for congenital heart disease (CHD). Boston Children's Hospital estimates that nine out of every 1,000 infants born in the United States are born with a congenital heart abnormality, and that one-third of these need intervention to prevent death in their first year. It is now known that problems can occur years after CHD repair, and that ongoing cardiology follow-up is essential to prevent or detect serious complications.
Unfortunately, many of those who had CHD surgery as children have not had regular follow-up, and so these complications often come to light when the now-adult patient seeks care in a noncardiac setting. For this reason, it is important for all nurses, not just those in the cardiac setting, to be aware of CHD and of its long-term complications, which can be related either to the disease itself or to the specific repair. For more on congenital heart defects, how they are repaired, and their long-term outcomes, see this month's CE feature, "Long-Term Outcomes After Repair of Congenital Heart Defects: Part 1."-Michael Fergenson, senior editorial coordinator