The care of adult patients with congenital heart defects: a new challenge.

The aim of the present article was to point out some of the more common challenges and needs for adult patients with congenital heart defects. We may reasonably calculate a population approximating 80,000 to 100,000 patients in Italy. The profile of this patient population will change over the next few decades. Not all congenital heart defects require the same level of expertise; for this reason an integrated national service is required. Ideally, specialist units should be established in appropriate geographic areas; complex patients need to be grouped according to the expertise, experience and management they require. Less specialized regional centers and outpatient clinics in interconnected districts with GUCH units should be created. Specialist units should accept responsibility for educating the profession, training the specialists, and sharing particular skills between each other. The debate on this subject is far from over; we wish to contribute to and stimulate the discussion.