(Circulation. 2001;103:2637.)
© 2001 American Heart Association, Inc.
Clinical Cardiology: New Frontiers |
Challenges Posed by Adults With Repaired Congenital Heart Disease
From the Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, Calif (J.K.P.) and the Adult Congenital Heart Disease Clinic, Mayo Clinic, Rochester, Minn (C.A.W.).
Correspondence to Joseph K. Perloff, MD, UCLA Division of Cardiology, Room 47-123 CHS, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1679. E-mail josephperloff@earthlink.net
Key Words: heart defects, congenital • heart diseases • surgery
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Introduction |
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"Pediatric Congenital Cardiac Becomes a Postoperative Adult: The Changing Population of Congenital Heart Disease," which was written in 1973,1 was the first publication devoted to what was destined to become a new field of special cardiovascular interest. Subsequent decades witnessed the maturity of this new subspecialty, which was formally recognized at the 22nd Bethesda Conference in 1990.2 It is altogether fitting for Circulation to include the present article in "Clinical Cardiology: New Frontiers." The present article can be considered a sequel to the 1973 article, which dealt with the types of surgical interventions, the effects of those interventions on survival patterns, the desirability of primary anatomic repair in infancy, and the importance of postoperative residua and sequelae.1 The 1973 article opened by stating: "It is now possible to perform palliative or corrective surgery on almost all congenital cardiac anomalies, even the most complex ... Survival patterns are affected, often profoundly. We are therefore confronted with a changing population of congenital cardiacs ... However, we are obliged to look beyond the present and define our ultimate goal. What do we seek to accomplish? The answer is clear. Our efforts should focus on the quality of long-term survival."1
Long-term survival is chiefly concerned with the growing
number of postoperative patients who require continuing medical
surveillance.3 What is needed
is a new generation of cardiologists with a career interest in adult
congenital heart disease; these highly trained specialists function
best within tertiary care facilities designed for the comprehensive
care of adult patients. With
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