Adult Congenital Heart Disease. Follow-Up Pattern of Care

After an early experience reported in this Journal in 2010 and a more detailed analysis published in 2020, there are now over 1600 patients registered in our outpatient clinic. This acquired eighteen years’ experience allowed us to face several situations related to the unit dynamics and to individual patient problems, which we believe might be useful for those particularly in charge of the new emerging unities and also for those already established. Adult congenital heart disease (ACHD) patients have a prevalence of 4 to 6/1.000 individuals^, and most of them have the peculiar profile of a long-standing disease frequently started at birth and often submitted to a cardiovascular intervention. Dr Joseph Perloff, in a landmark article in 1973, emphasized that ACHD patients would never be cured and sequelae and residua after invasive treatment should be expected in most of them. In fact, over the subsequent years, studies have shown that the incidence of residual lesions is almost uniform, justifying routine surveillance, except for a minority of individuals with very simple lesions. As discharge is rare, the number of patients is expected to increase progressively, which might interfere with proper care. Four topics seem to be crucial for us regarding follow-up and are briefly reminded below.

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