Adults with congenital heart disease transition.
OBJECTIVE
At present, 85-90% of those born with congenital heart disease (CHD) grow up to become adults. With few exceptions, reparative surgery is not curative and requires long-term surveillance. Caregivers could be changed from pediatric cardiologists to adult CHD specialists (or cardiologists) during this process. This study will focus on the current practice of transition in CHD.


RESULTS
Residua and sequelae may progress in severity with age and induce late complications, such as arrhythmias, cardiac failure, thromboembolism, sudden cardiac death, reoperation, cardiac intervention, and arrhythmia ablation. There are other obstacles that further complicate adult CHD, including pregnancy and delivery, noncardiac surgery, psychosocial problems, health insurance coverage, and extracardiac complications, making close follow-up and proper management mandatory. Because of this, several specialized centers have been established to respond to this need, and several studies focusing on transition have been published recently.


CONCLUSIONS
Provision of comprehensive care by multidisciplinary teams including adult CHD specialists, adult and pediatric cardiologists and cardiovascular surgeons, specialized nurses, and other specific disciplines are the fundamental features in care facilities for adult CHD. Training and education should be focused on adult CHD fellows who represent the next generation that will assume responsibility for this patient population. Proper transition from pediatric cardiologists and cardiovascular surgeons to adult CHD care team, including adult CHD specialists and/or cardiologists trained in this field, is mandatory.
Department of Cardiology, Cardiovascular Center, St Luke's International University, Tokyo, Japan.
Koichiro
K
Niwa
D000293:Adolescent; D000328:Adult; D002300:Cardiac Care Facilities / Q000458:organization & administration*; D016507:Cardiology Service, Hospital / Q000458:organization & administration*; D018450:Disease Progression; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy*; D006801:Humans; D011183:Postoperative Complications / Q000534:rehabilitation; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care / Q000592:standards*; D011788:Quality of Life; D012086:Reoperation; D016019:Survival Analysis; D060305:Transition to Adult Care; D016896:Treatment Outcome