Frankfurter Claudia, Asgar Anita W, Webb John G, Cantor Warren J, Velianou James L, Gobeil François, Chan Albert W, Welsh Robert C, Love Michael P, Wood David A, McKenzie Kevin, Horlick Eric M
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Institut de Cardiologie de Montréal, Montréal, Canada.
Can J Cardiol. 2017 Sep;33(9):1201-1205. doi: 10.1016/j.cjca.2017.05.018. Epub 2017 May 30.
Once considered a childhood disease, the number of adults living with congenital heart disease (CHD) has now exceeded the number of pediatric patients. The landscape of percutaneous intervention for adult congenital heart disease (ACHD) has evolved over the past decade and has yet to be characterized in Canada. The aim of this study was to begin to understand the current infrastructure underlying ACHD interventions in Canada and to characterize the type and number of interventions being carried out across the country. A cross-sectional national survey was distributed by e-mail to all cardiac catheterization laboratory directors in 2015. All Canadian laboratories involved in ACHD interventions responded, encompassing 19 institutions spanning 69 cardiac catheterization laboratories. A total of 1451 percutaneous interventions were recorded. Nationwide, the most common simple ACHD interventions were for atrial septal defect and patent foramen ovale closures. The most common ACHD interventions of increased complexity were for coarctation stenting and transcatheter pulmonary valve implantation. There was a marked clustering of procedures in Ontario, Québec, British Columbia, and Alberta in keeping with Canada's population-density distribution. A total of 23 ACHD operators were identified, half of whom had ACHD-specific fellowship training. These data can be used as a starting point to inform the present state of affairs in the area and lay the groundwork for further work to assess resource allocation and human resource planning for the care of patients with ACHD in Canada.
先天性心脏病（CHD）曾经被认为是一种儿童疾病，如今患有先天性心脏病的成年人数已超过儿科患者数量。在过去十年中，成人先天性心脏病（ACHD）的经皮介入治疗领域不断发展，而加拿大尚未对其进行描述。本研究的目的是开始了解加拿大ACHD介入治疗的当前基础架构，并描述全国范围内正在进行的介入治疗的类型和数量。2015年，通过电子邮件向所有心脏导管实验室主任进行了一项全国性横断面调查。所有参与ACHD介入治疗的加拿大实验室均作出回应，涵盖19个机构的69个心脏导管实验室。共记录了1451例经皮介入治疗。在全国范围内，最常见的简单ACHD介入治疗是房间隔缺损和卵圆孔未闭封堵术。复杂性增加的最常见ACHD介入治疗是缩窄支架置入术和经导管肺动脉瓣植入术。与加拿大的人口密度分布一致，安大略省、魁北克省、不列颠哥伦比亚省和艾伯塔省的手术明显集中。共确定了23名ACHD手术医生，其中一半接受过ACHD专项进修培训。这些数据可作为一个起点，以了解该领域的现状，并为进一步评估加拿大ACHD患者护理的资源分配和人力资源规划奠定基础。
