Increasing Survival in Patients With Congenital Heart Disease—A Glass Half Full or Half Empty?

To the Editor We read with great enthusiasm the Original Investigation by Mandalenakis et al¹ in a recent issue of JAMA Internal Medicine. Comparing patients with congenital heart disease (CHD) born between 1970 and 1993 with matched controls, Mandalenakis et al¹ showed an absolute and relative increase in survivorship in patients with CHD. Not surprisingly, the highest mortality risk was found among young children and in the most complex defects. Using a large nationwide Swedish registry and a robust design, this study¹ supports our findings from the Quebec CHD Database²: deaths in CHD have shifted away from infants and toward adults, with a steady increase in age at death and decreasing mortality.