Managing Adult Congenital Heart Diseases in the Modern Era

Adults with congenital heart disease now outnumber children with the condition in many health systems — and they increasingly reach the catheterisation laboratory, the echo suite and the emergency department of cardiologists who were never formally trained in congenital anatomy. Managing Adult Congenital Heart Diseases in the Modern Era is written for that clinician.

Across 21 chapters, Dr A M Thirugnanam brings an interventional cardiologist's perspective to the full spectrum of ACHD care — from embryology and genetics to transcatheter therapy, heart failure, pregnancy and the design of a modern ACHD programme. Each chapter opens with learning objectives and closes with key clinical takeaways for the expert cardiologist, supported by summary tables, surveillance protocols and selected references.

Inside you will find:
- The modern ACHD population — shifting demographics, the ACC/AHA complexity classification, sequential segmental analysis and risk stratification
- Embryology and congenital anatomy through the interventionalist's lens — conduction system landmarks, coronary variants and the surgically repaired heart
- The genetic architecture of CHD — 22q11.2 deletion, Turner, Williams and Noonan syndromes, connective tissue aortopathies, genetic testing and counselling
- Multimodality imaging — advanced echocardiography, CMR flow quantification and tissue characterisation, and CT for interventional planning
- Functional assessment, biomarkers and integrated risk stratification
- Diagnostic and interventional catheterisation — shunt quantification, PVR and operability, vasoreactivity testing, Fontan and systemic RV haemodynamics
- Lesion-by-lesion management: ASD, VSD, AVSD and PDA; tetralogy of Fallot; LVOT obstruction and bicuspid aortic valve; coarctation; transposition after atrial switch, arterial switch and ccTGA; the Fontan circulation; Ebstein anomaly; pulmonary atresia; DORV and truncus arteriosus; heterotaxy
- Aortopathy — bicuspid valve, Marfan syndrome and HTAD, with intervention thresholds
- Eisenmenger syndrome and pulmonary arterial hypertension in CHD
- Heart failure, arrhythmia, device therapy and transplantation
- Pregnancy, non-cardiac surgery and infective endocarditis
- Building the ACHD programme of tomorrow — multidisciplinary teams, transition care and artificial intelligence

Written for interventional and general cardiologists, ACHD and imaging specialists, and cardiology fellows preparing for board examinations, this is a practical, evidence-based reference for the adult with congenital heart disease — before, during and after intervention.

About the author
Dr A M Thirugnanam, MD, MSICP, FSCAI, Ph.

D., is a Senior Interventional Cardiologist based in Hyderabad, India, specialising in complex coronary and structural heart intervention. He is the founder of the Academy of Elite Doctors, a medical educator and researcher, and the author of numerous cardiology textbooks.