Lifelong Specialised Care of Adults with Congenital Heart Disease a Luxury or State of the Art?

The medical and surgical advances which have occurred in the second half of the twentieth century in the diagnosis and treatment of congenital heart disease allowed the survival of an increasing number of patients to adulthood. After an intervention or cardiac surgery many of these patients consider themselves “cured”, but most of them will have residua and sequelae which require lifelong surveillance. The adult cardiologist dealing with this patient population faces many challenges, such as deciding about the indication and the timing for a re-intervention and/or a re-operation, the treatment of arrhythmias and of systemic ventricular dysfunction, and the prevention of endocarditis and of pulmonary vascular disease. Furthermore, these patients have special needs with respect to reproduction, employment and insurability. The purpose of this article is to emphasise the importance of a specialised lifelong follow-up of adults with congenital heart disease in order to provide optimal care.