Amaral Fernando Tadeu Vasconcelos, Manso Paulo Henrique, Schmidt André, Sgarbieri Ricardo Nilson, Vicente Walter Villela de Andrade, Carbone Junior Clovis, Somerville Jane
Hospital das Clinicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR.
Imperial College, London, GB.
Rev Bras Cir Cardiovasc. 2015 Jul-Sep;30(3):373-9. doi: 10.5935/1678-9741.20150037.
During the last decades, advances in diagnosis and treatment of congenital heart disease have allowed many individuals to reach adulthood. Due mainly to the great diagnostic diversity and to the co-morbidities usually present in this age group, these patients demand assistance in a multidisciplinary facility if an adequate attention is aimed. In this paper we reviewed, based in the international literature and also on the authors' experience, the structural conditions that should be available for these patients. We highlighted aspects like the facility characteristics, the criteria usually adopted for patient transfer from the paediatric setting, the composition of the medical and para- medical staff taking into account the specific problems, and also the model of outpatient and in-hospital assistance. We also emphasized the importance of patient data storage, the fundamental necessity of institutional support and also the compromise to offer professional training. The crucial relevance of clinical research is also approached, particularly the development of multicenter studies as an appropriate methodology for this heterogeneous patient population.
在过去几十年中,先天性心脏病诊断和治疗方面的进展使许多患者能够成年。主要由于诊断方式的多样性以及该年龄组通常存在的合并症,如果要给予充分关注,这些患者需要在多学科机构接受治疗。在本文中,我们基于国际文献以及作者的经验,回顾了应为这些患者提供的结构条件。我们强调了诸如机构特征、通常采用的将患者从儿科环境转出的标准、考虑到特定问题的医护人员组成,以及门诊和住院治疗模式等方面。我们还强调了患者数据存储的重要性、机构支持的基本必要性以及提供专业培训的承诺。我们也探讨了临床研究的关键相关性,特别是开展多中心研究作为针对这类异质性患者群体的合适方法。