Adults or Big Kids: What Is the Ideal Clinical Environment for Management of Grown-Up Patients With Congenital Heart Disease?

Case mix varies with the clinical environment, with more complex procedures performed at GH plus CHS. The optimal environment for complex GUCH surgery involved CHS operating within CH. Initiatives to develop adult congenital centers dedicated to the care of GUCH patients are warranted, and should include congenital heart surgeons operating in a setting mimicking children's hospitals.