Comprehensive patient care best serves the adult with congenital heart disease

Comprehensive care is the cornerstone of the management of adults with congenital cardiac disease (CHD). Such patients are not cured by the surgery that was undertaken in childhood but are more correctly repaired and therefore require life‐long surveillance from medical professionals who are specialised in their care.CHD is a multisystem disorder: consequently, there is a need for close collaboration between a number of different specialities. During the course of a patient's lifetime they need care from disciplines such as cardiovascular imaging, interventional cardiology, congenital cardiac surgery, and anaesthesia, electrophysiology, heart failure, transplantation, palliative/advanced care, genetics, high‐risk pregnancy services, hepatology, and psychology amongst others. The care of the adult with CHD is therefore dependent upon a team of highly qualified health providers. Co-ordination of such care is best organised by the adult congenital cardiologist who is knowledgeable in the anatomy and pathophysiology and how that impacts the individual's health. The physician must act as an advocate for the patient, educating both the patients and other medical professionals about their conditions to ensure safe and adequate care.In this review we will define comprehensive care in the setting of the adult with CHD. We will outline such care in light of a patient journey from the transition process, through surveillance and to end of life care. Our focus is very much to describe our own philosophy of what that care should be and the ideal of what we hope to practice at the Toronto Congenital Cardiac Centre for Adults.