Abstract
c i s u t w t d 1. Why should patients with congenital heart disease CHD) transition to adult CHD (ACHD) programs? Answer: The 21st century has seen a remarkable shift in he course of care for patients with CHD. Previously, few of hese patients were expected to live to adulthood. With dvances in surgical technique and medical management, he majority of children born with CHD are expected to lead ull adult lives. It is estimated that as many as 500,000 adult atients with CHD live in the United States today and face dult medical issues. They require internal medicine, gasroenterology, gynecology, electrophysiology, and other ubspecialty care. Although the locus of care remains conroversial, the 32nd Bethesda Conference on the Care of dult with CHD provided guidelines and recommends the ransition to adult providers. In addition, adult patients with HD should be cared for in hospitals that have adult nursing xperience in CHD to help maintain and support a successul transition. 2. Who should care for adult patients with CHD? Answer: Ideally, physicians, advanced practice nurses, nd physician assistants with special training in ACHD hould care for the patients, along with support team as utlined in the 32nd Bethesda Conference report on CHD. Other options in many communities without cariologists having an ACHD fellowship background may nclude adult-trained cardiologists with ACHD experience, r pediatric cardiologists with ACHD experience, in conunction with a closely communicating team of adult interal medicine and subspecialty providers. In addition, care ay be shared with a regional center having primary reponsibility in the location of the patient. Although it is true hat in many regions CHD knowledge and clinical experi-
Published Version
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