Adult Congenital Heart Disease Intervention: The Canadian Landscape

Area of Science:

• Cardiology
• Interventional Cardiology
• Public Health

Background:

• Congenital heart disease (CHD) is increasingly diagnosed in adults, surpassing pediatric cases.
• The current state of percutaneous interventions for adult congenital heart disease (ACHD) in Canada is not well-characterized.
• Understanding ACHD intervention infrastructure is crucial for patient care planning.

Purpose of the Study:

• To assess the current infrastructure for ACHD interventions in Canada.
• To characterize the types and volume of percutaneous interventions performed for ACHD nationwide.
• To establish a baseline for future resource and human resource planning in ACHD care.

Main Methods:

• A national cross-sectional survey was conducted in 2015.
• The survey targeted directors of all cardiac catheterization laboratories in Canada.
• Data on ACHD interventions were collected from all responding institutions.

Main Results:

• 1451 percutaneous interventions were recorded across 19 institutions and 69 laboratories.
• Common simple interventions included atrial septal defect and patent foramen ovale closures.
• Complex interventions included coarctation stenting and transcatheter pulmonary valve implantation.
• Procedures were concentrated in Ontario, Québec, British Columbia, and Alberta.
• 23 ACHD operators were identified, with 50% having specialized fellowship training.

Conclusions:

• This study provides the first national overview of ACHD interventions in Canada.
• The findings highlight regional disparities and the need for specialized training.
• These data serve as a foundation for improving ACHD care, resource allocation, and workforce planning.