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[Problems in adolescents and adults with congenital heart defects].

The first palliative operations of congenital heart disease in the 1940s and 1950s, and then open heart surgery in the 1960s, have resulted in survival of patients whose follow-up is now over 30 years. Problems of patients with congenital heart disease are cardiac (pulmonary hypertension, systemic hypertension, dysrhythmias, endocarditis, cerebral insults, etc.), and noncardiac (scoliosis, intrathoracic adhesions, cosmetic problems, pregnancy, physical activity, employment, etc.). A pediatric cardiologist usually follows up such patients until adolescence, however, after that time they remain without physician's care who followed them in their childhood, being transferred for further controls and follow-up to internists-cardiologists. Many difficulties arise since internists-cardiologists are not properly trained in this particular sense, and pediatricians are not trained to follow-up adult patients. The care for a patient should be coordinated. To care for an adolescent, who was the child with congenital heart disease, pediatrician and cardiologist have to work at the same medical centre. The follow-up should continue as a team work, in which, besides pediatrician and cardiologists, cardiosurgeon, psychologist, psychiatrist, obstetrician, specialist for physical medicine and social worker should be included. A correction of educational plan is mandatory.