Fifty years ago, babies born with complex congenital heart defects had a less than five per cent rate of survival to adulthood, as surgical strategies that would eventually treat many of these patients were still in their infancy or not available.
Today, more than 90 per cent of these babies make it into adulthood, creating a whole new patient demographic where there are currently more adult patients living with congenital heart disease than children – and medicine must now do its best to keep up.
The rapidly growing field of adult congenital heart disease (ACHD) deals with patients who had one or more structural abnormalities of the heart present at birth. Thanks to advances in diagnosis and treatment, these people survive to adulthood despite their birth defect, but need continued follow-up and care throughout their adult lives.
"In the last few decades, this specialty [ACHD], has really taken off," explains Dr. Rachel Wald, a cardiologist with the Toronto Congenital Cardiac Centre for Adults (TCCCA) at the Peter Munk Cardiac Centre (PMCC).
"Initially, these children simply didn't survive, and that's just not the case anymore. Now this expanding patient population requires a specialized team of physicians and nurses to look after them."
To treat the rapidly growing number of ACHD patients in Canada, the TCCCA and the PMCC were at the forefront of the creation of a multidisciplinary team of specialized cardiologists and congenital heart surgeons who work to marry the pediatric and adult cardiac worlds. The clinic is one of the oldest and largest of its kind in the world, with more than 9,500 active patients.
"Within ACHD, the ties to the pediatric world are exceptionally strong because congenital heart disease was once strictly a pediatric condition," explains Dr. Wald, originally a pediatric cardiologist who further sub-specialized in the care of adults with congenital heart disease.
Treating congenital heart defects in adults often requires an understanding of the unique complexities of each patient, as many have more than one medical issue.
"We believe the best way to balance out this team is to have a diverse array of physicians with complementary vantage points," adds Dr. Wald.
The third annual Peter Munk Cardiac Centre (PMCC) magazine published by
The Globe and Mail focuses on why Canada's premier cardiac centre is known for being “the heartbeat of innovation.” The magazine explores the PMCC model that supports the creation, development and evolution of innovative ideas into action – making “today's idea, tomorrow's practice.” It also examines the impact that a culture of innovation has on the way cardiovascular care is delivered now and into the future.