Congenital heart disease (CHD), with an incidence of 1%, is one of the most common congenital defects. Advances and developments in paediatric cardiology and paediatric cardiovascular surgery over the past several decades have saved the lives of infants and neonates with CHD who would have died without these advances in medicine, and have led to more than 90% of these patients surviving to adulthood. There is a large and still-growing population of adults with CHD. However, surgical or catheter interventions have been shown to be reparative, not curative. The majority of patients with CHD will require lifelong follow-up with a specialised team. Many of these patients will face further surgery, cardiac failure and arrhythmia management during adulthood with advancing age. If they are managed inappropriately, they will experience cardiac failure and premature death. Although provision of care for children with CHD has improved in the Asia-Pacific area recently, the number of adults with CHD will increase in the near future. However, clinical services for adults with CHD are scarce, particularly in this region.
CHD remains a small part of adult cardiology. Paediatric cardiologists who are familiar with cardiac morphology and pathophysiology even in complex CHD may continue to care for these patients with CHD after they grow up into adulthood. However, there are clearly different health issues for adults with CHD compared with children with CHD and they are beyond the scope of paediatric cardiology. These issues include obstetrics, electrophysiology, cardiac failure, coronary artery disease, psychosocial problems, non-cardiovascular surgery and insurance. In addition, adult cardiologists with a limited knowledge of CHD cannot work in this special field of medicine without formal training in adult CHD. Therefore, more physicians who are specialists in this field are necessary in the Asia-Pacific region.
Specialised clinics for adults with CHD were established around 30 years ago in the UK and US and have been spreading all over North America and Europe for the last 20 years. Trainees from the Asia-Pacific region in these clinics have been establishing similar centres in countries such as Japan, Korea, Australia, New Zealand and other countries. The number of adults with CHD is growing constantly in the Asia-Pacific area. Therefore, specialised teams and care centres for adults with CHD are mandatory in this region. The good news is that the Asia-Pacific Society for Adult Congenital Heart Disease has been established, and its first medical meeting was held at Jeju Island, Korea, in May 2008. Representatives from 12 countries in the Asia-Pacific region attended.
I hope this movement provides the future development of care for adults with CHD and that the new society will facilitate international collaboration. Through this journal, Asia-Pacific Cardiology, we can exchange knowledge of the field of adult CHD and develop friendships throughout the region.