In Denmark, about 500 children are born annually with congenital heart defects. The causal pathway is unknown but many heart defects are caused by genetic anomalies. The defect is often diagnosed in infancy, but less serious heart defects are diagnosed in childhood and adulthood. Most of the heart defects are treated surgically or by catheter treatment and 98% of the patients survive treatment and the majority live into adulthood. Still, some congenital heart diseases lead to decreased life expectancy or increased morbidity.

The Center for Congenital Heart Disease focuses on several aspects of congenital heart disease.
The frequency of different types of heart defects, life expectancy, morbidity, type and level of education, job opportunities and reproduction is investigated in epidemiological studies. Pulmonary hypertension and the effect on the heart are examined in animal studies as well as the effect of medication at different ages in childhood. The influence of the heart-lung-machine on the organ systems has been studied in detail by researchers at the Center for Congenital Heart Disease .
Blood coagulation is affected in patients with some types of congenital heart disease; in general, blood coagulation is affected during surgery. A group of researchers are interested in studying the treatment of blood coagulation disorders.
In cohort studies, the impact of physical activity is examined in patients with the most common congenital heart diseases.

Based on recent successful treatment results in patients with congenital heart disease, more than 15,000 adults live with a treated heart defect in Denmark.
Their special conditions are still relatively unknown and are basis for epidemiological and clinical studies.

Ongoing projects
1. Right ventricular physiology
In animal models on rats, rabbits and pigs and in human studies, the muscle fiber direction, enzyme systems, haemodynamic conditions, anatomic and pathophysiological treatment of pulmonary stenosis, pulmonary hypertension and pulmonary insufficiency are examined. The effect of both medical and surgical treatment is investigated

2. Long term outcome in patients with ventricular septal defects (VSD). Lung function, echocardiography, MR scan and CPX testing of adults with small VSDs and after surgical repair? Of the VSD.
Cardiopulmonary function is examined in adults with small VSDs and in patients operated for VSDs during rest and physical activity. The cardiac function is examined with an advanced MR technique and echocardiography; lung function is examined during physical activity.

3. Long term outcome after correction of septal defects, CoA and TGA
Epidemiological and clinical follow-up studies examine function, morbidity, mortality, and possibilities for addition to the family? Family disposition?.

4. Outcome of neurodevelopment in patients with congenital heart defect
The development of the brain in patients with congenital heart disease is examined and compared to a control group without heart defect using registries (such as Danish Civil Registration System and National Centre for Register-based Research) and during direct investigations using advanced MRI techniques.

Milestones/publications
Center for Congenital Heart Disease was established at Aarhus University Hospital in 2007. The Center consists of professionals from the Department of Obstetrics and Gynaecology, Department of Cardiology, Department of Cardiothoracic and Vascular Surgery, Department of Anaesthesiology and Intensive Care, Department of Radiology and Department of Clinical Genetics.


Methods
• Genetic and molecular techniques
• Animal experimental models in mice, rats, rabbits and pigs
• Randomised (double) blinded placebo controlled investigations of treatment modalities such as kidney protection during surgery
• Advanced studies of physical activity with echocardiography including tissue Doppler during supine cycling, MR scan during cycling, and cardiac output measurements during exercise with breath-by-breath gas exchange and oxygen uptake.
• Electrophysiological measurements
• Epidemiological techniques and access to data in nationwide registers

Important international collaborators
Our most important collaborators are Sick Kids, Toronto, Canada, Great Ormond Street Hospital for Children, London, England and Children´s Hospital of Philadelphia, Philadelphia, USA.