{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T02:43:37Z","timestamp":1785206617485,"version":"3.55.0"},"reference-count":46,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Early surgery and improved medical care have led to the increased survival of neonates with congenital heart disease (CHD), who now commonly reach adulthood. Among adults with CHD, a growing subgroup is represented by middle-aged and even elderly patients. In this elderly population, acquired cardiac and extracardiac comorbidities represent the main cause of morbidity and mortality; the control and correction of cardiovascular risk factors or an appropriate check for extracardiac complications (such as malignancies) is therefore of paramount importance. Complications and frailty syndrome appear to occur earlier in ACHD than in the general population due to a frequent discrepancy between chronological and biological age. Multiple stressors throughout life (hemodynamic abnormalities, cardiac operations and interventional procedures, the placement of foreign materials) that result in a chronic inflammatory response are among the leading causes of premature senescence. This review is aimed at assessing the characteristics and special needs of this elderly ACHD population with a view to proposing novel models for the organization of extended care.<\/jats:p>","DOI":"10.3390\/diagnostics15040481","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T10:26:12Z","timestamp":1739787972000},"page":"481","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Congenital Heart Disease After Mid-Age: From the \u201cGrown-Up\u201d to the Elderly"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-4333","authenticated-orcid":false,"given":"Francesca","family":"Bonanni","sequence":"first","affiliation":[{"name":"ACHD Unit, Department of Cardiology, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6530-9170","authenticated-orcid":false,"given":"Chiara","family":"Servoli","sequence":"additional","affiliation":[{"name":"ACHD Unit, Department of Cardiology, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4697-6303","authenticated-orcid":false,"given":"Gaia","family":"Spaziani","sequence":"additional","affiliation":[{"name":"ACHD Unit, Department of Cardiology, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1392-8839","authenticated-orcid":false,"given":"Elena","family":"Bennati","sequence":"additional","affiliation":[{"name":"ACHD Unit, Department of Cardiology, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Di Filippo","sequence":"additional","affiliation":[{"name":"ACHD Unit, Department of Cardiology, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia Ksenia","family":"Cirri","sequence":"additional","affiliation":[{"name":"ACHD Unit, Department of Cardiology, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzia","family":"Giaccardi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Santa Maria Annunziata Hospital, 50012 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iacopo","family":"Olivotto","sequence":"additional","affiliation":[{"name":"ACHD Unit, Department of Cardiology, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"},{"name":"Department of Cardiology, Santa Maria Annunziata Hospital, 50012 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Favilli","sequence":"additional","affiliation":[{"name":"ACHD Unit, Department of Cardiology, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1161\/CIRCULATIONAHA.113.008396","article-title":"Lifetime prevalence of congenital heart disease in the general population from 2000 to 2010","volume":"130","author":"Marelli","year":"2014","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/eurheartj\/ehaa554","article-title":"2020 ESC Guidelines for the management of adult congenital heart disease","volume":"42","author":"Baumgartner","year":"2021","journal-title":"Eur. 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