Abstract 4682: Status of Adult Congenital Heart Disease Clinics in Canada: A Survey on Infrastructure, Resources and Clinical Volumes
There are more adults than children with congenital heart disease in Canada. A significant proportion of patients with adult congenital heart disease (ACHD) require ongoing expert care. Published data detailing volumes and resources of Canadian ACHD clinics are currently lacking. All Canadian Adult Congenital Heart (CACH) Network affiliated ACHD centers were asked to collect data on outpatient clinic and procedural volumes for the 2007 calendar year. A survey on infrastructure and human resources was sent to each site. All 15 centers registered with the CACH network responded. The total number of active (defined as booked for follow-up) patients followed in ACHD clinics in Canada is 21 879. Median number of registered patients per clinic = 1650 (IQR: 600, 2246). Median number of active patients per clinic = 1132 (IQR: 585,1816). A mean of 7±3 MDs are affiliated with each center. All centers have pediatric cardiologists providing consultative and/or procedural roles. Twenty-two out of the 102 (21%) affiliated MDs received formal ACHD training. Mean number of clinics/week = 2±2 (range = 0.25– 6). Eleven centers (73%) have dedicated nurses (mean = 1.2±0.9 FTE) and 6 (40%) have clerical support. Five sites (33%) offer ACHD fellowships. Eleven sites (73%) have dedicated ACHD databases. For the 2007 calendar year, median number of patient visits, per site, was 581 (IQR: 241,1333). Mean ACHD specific procedural volumes, per site, for 2007 were: diagnostic caths = 21±33, percutaneous interventions = 27±28, surgery = 26±30. Current ACHD mean estimated wait times are: non-urgent consult = 4±2 mths, percutaneous procedure = 4±3 mths, surgery = 4±2 mths. ACHD estimated wait times were beyond Canadian recommended targets at 11 sites (73%) for non-urgent consult, at 8 sites (53%) for percutaneous intervention and 13 sites (87%) for surgery. Is spite of universal access to health care, there are less than 25 000 active patients followed in ACHD clinics in Canada. Pediatric cardiologists play an active role at all Canadian ACHD clinics. A minority of ACHD caregivers has formal training in ACHD. In most sites estimated waiting times for ACHD services are beyond Canadian recommended targets.