Implementation of the American College of Cardiology/American Heart Association 2008 Guidelines for the Management of Adults With Congenital Heart Disease.

Am J Cardiol. 2015 Aug 1;116(3):452-7. doi: 10.1016/j.amjcard.2015.04.041. Epub 2015 May 9.

Implementation of the American College of Cardiology/American Heart Association 2008 Guidelines for the Management of Adults With Congenital Heart Disease.

Goossens E1Fernandes SM2Landzberg MJ3Moons P4.

CommentThis article by Goossens and colleagues investigated the type of “health care professional, care setting, and frequency of outpatient visits" in a group of young adults with CHD.  The authors identified 306 patients, age 23 years at time of data collection, who had an outpatient cardiology appointment before the age of 18 years (between 2001-2005).  On follow up, 68.8% of patients were in cardiac care, but only one-quarter had transitioned to a formalized ACHD clinic.   A small number (7%) of patients had withdrawn from care and 25% were “untraceable."  Factors associated with patients being “untraceable” were lower number of surgeries, insurance issues, and being non-white.  This study highlights that many adults continue to be cared for by pediatric cardiologists.  The authors suggest that standardization of ACHD specialty care might allow pediatric cardiologists to have the confidence to transfer adult patients to ACHD care more routinely.