Gender-specific algorithms recommended for patients with congenital heart defects: review of the literature.

In the past surgeons did not consider gender to be an important factor in the treatment of congenital heart defects (CHDs). However, gender differences in morbidity and mortality are well documented for acquired heart disease, but data are sparse for CHDs. The purpose of this review is to update the knowledge on the influence of gender on the size and function of the heart during childhood and adolescence. Gender does play an important role already in childhood documented by significant differences in cardiac chamber size, cardiac function, and metabolic exercise testing in healthy young reference populations. Illustrated by the example of tetralogy of Fallot (ToF), gender influence in CHD also appears relevant, for example, biventricular volumes and mass-indexed to body surface area-are significantly higher in male ToF patients, ∼10% for volumes and ∼20% for muscle mass. Accordingly, there is also new evidence that gender has an important role on the outcome of CHDs as shown in recent registry studies which underlines the need for gender-specific algorithms in CHD.