Euro Heart Survey on adult congenital heart disease: concern for the complexity of care.

Progress in paediatric cardiac surgery over the last decades resulted in a growing number of adult patients with (surgical corrected) congenital heart defects. Most of these patients require lifelong care, as the long-term outcome of the complex surgical procedures is often complicated by heart failure, atrial or ventricular arrhythmias, pulmonary hypertension, or endocarditis. In addition, surgical re-interventions are frequently necessary in case of, for example, obstruction of conduits or residual defects. Taking into account the complexity of the late post-operative sequelae, adequate monitoring and care for the adult patient with a congenital heart defect are of paramount importance. Therefore, guidelines for medical, surgical, and psychosocial management of adults with congenital heart disease were developed. However, little is known about the actual implementation in routine clinical practice. So far, only one survey has evaluated the delivery of care for adults with congenital heart disease at the six tertiary centres in North America and Europe. Moons et al. report the outcome of a study, which is a first attempt to evaluate the implementation of structurized care for adults with congenital heart defects at the multiple centres in Europe as recommended by the Euro Heart Survey on Adult Congenital Heart Disease.