Wadia Hospital Launches the first of its kind dedicated Grown-up Congenital Heart Disease (GUCH) clinic in Western India
Bai Jerbai Wadia Hospital for Children Treats over 1,000 Children with Congenital Heart Disease Every Year for children born with congenital heart defects, timely diagnosis and treatment during childhood can give them the opportunity to survive, thrive and grow into adulthood. However, reaching adulthood does not always mean that their congenital heart condition no longer requires medical attention. Recognising the need for continued specialised cardiac care, Bai Jerbai Wadia Hospital for Children, Mumbai, has launched a dedicated GUCH /Adult Congenital Heart Disease (ACHD) Clinic for adults living with congenital heart disease who were treated or followed up during childhood.
With major advances in diagnosis, cardiac surgery, catheter-based interventions, intensive care and neonatal care, an increasing proportion of children with congenital heart disease are now surviving well into adulthood. This has created an entirely new group of patients - adults who have previously undergone surgery or interventions during childhood and now require specialised lifelong cardiac follow-up. The new OPD will offer continued specialised cardiac care, appropriate investigations, counselling, risk assessment and timely intervention based on each patient’s medical needs. A key feature of the clinic is the joint involvement of Paediatric Cardiologist Dr. Kshitij Sheth and Adult Cardiologist Dr. Hetan Shah, bringing together their expertise as patients move from childhood into adult cardiac services.
Congenital heart disease refers to structural problems of the heart that are present from birth. Although many patients can lead normal, active lives after treatment during childhood, successful childhood surgery does not necessarily mean that the condition has been permanently cured.
Dr. Kshitij Sheth, Paediatric Cardiologist, Bai Jerbai Wadia Hospital for Children, said, “Congenital heart disease is a condition that begins at birth, but the need for cardiac care may continue well beyond childhood. Advances in treatment have allowed many children with complex heart conditions to survive and grow into adulthood. However, childhood surgery or intervention does not always mean that the heart will never require attention again. Adults may have residual or develop recurrent issues, related to previous surgeries or interventions. They may also have questions related to exercise, employment, pregnancy, contraception, lifestyle and long-term cardiovascular risk. The aim of the GUCH / ACHD clinic is therefore to move from simply treating a childhood heart defect to providing lifelong, structured and anticipatory care.”
Wadia Hospital already sees a significant number of patients who were treated for congenital heart disease during childhood and are now adults, with 15–20 adult congenital patients currently under follow-up. The new GUCH / ACHD clinic is intended not only for these existing adult patients but also for the much larger group of adults with congenital heart disease who may have discontinued follow-up after reaching adulthood.
For patients who have undergone cardiac surgery or catheter-based treatment during childhood, their previous medical history is particularly important. Their original diagnosis, operation, catheter intervention, imaging findings and complications provide valuable information for managing them as adults.
Dr. Hetan Shah, Adult Cardiologist, Bai Jerbai Wadia Hospital for Children, said, “Continuity of care is one of the most important objectives of the clinic. A patient’s previous diagnosis, operation, catheter intervention, imaging and complications provide extremely valuable information for managing them as adults. A dedicated GUCH/ ACHD service allows us to maintain this history and undertake regular clinical assessment, ECG, echocardiography and appropriate investigations, while identifying problems before they become clinically significant. It also provides a defined pathway for patients transitioning from paediatric to adult-oriented cardiac care rather than leaving them without follow-up once they cross the paediatric age group.”
The needs of adults with congenital heart disease are different from those of adults who develop heart disease later in life. These patients benefit from doctors who understand both their original congenital anatomy and their current adult cardiovascular needs.
Dr. Hetan Shah further added, “The collaboration between paediatric and adult cardiology is absolutely central to GUCH/ ACHD care. Congenital heart disease is anatomically and physiologically different from acquired adult heart disease, and these patients benefit from doctors who understand both their original congenital anatomy and their current adult cardiovascular needs. The GUCH/ ACHD model brings together the expertise of paediatric congenital cardiology with adult cardiology, cardiac imaging, electrophysiology, cardiac surgery and other relevant specialties. This collaborative approach ensures that the patient’s care evolves with age while retaining knowledge of their original congenital condition.”
The dedicated clinic will build on Wadia Hospital’s existing paediatric cardiac ecosystem, which includes paediatric cardiology, cardiac surgery, cardiac anaesthesia and intensive care, along with advanced echocardiographic and diagnostic facilities. The GUCH/ ACHD clinic will have particular emphasis on high-quality echocardiography, ECG and cardiac imaging, functional assessment and arrhythmia evaluation, with access to cardiac catheterisation, interventional and surgical expertise when required. This will allow patients to access a multidisciplinary congenital heart team familiar with their disease from childhood onwards.
Dr. Kshitij Sheth further added, “Our vision is to establish a clear and seamless pathway from diagnosis in infancy, through surgery or intervention and childhood follow-up, and eventually into adult congenital cardiac care. When a child undergoes a complex cardiac procedure at Wadia, our responsibility should not end when that child reaches 18 years of age. The patient’s cardiac condition may require monitoring even when they feel completely well. Regular assessment can help us understand changes in heart function, valves, rhythm and other aspects of their condition over time. The GUCH/ACHD clinic is an important step towards creating this continuum of care and ensuring that today’s children remain connected to specialised congenital cardiac services throughout their lives.”
Doctors also emphasise that adults who underwent congenital heart surgery or catheter-based treatment during childhood should not assume that follow-up is unnecessary simply because they feel well. Many adults who underwent congenital heart surgery or intervention as children can lead completely normal and active lives. However, some complications can develop silently and may only be detected through clinical examination, ECG, or echocardiography.
Dr. Hetan Shah further said, “Feeling well does not necessarily mean that the heart no longer needs monitoring. Many adults who underwent congenital heart surgery or intervention as children lead completely normal, active lives - which is exactly what we want. But some complications can develop silently and may only be detected through a clinical examination, ECG, or echocardiogram. Anyone who had congenital heart disease or underwent cardiac surgery or intervention during childhood should not wait for symptoms. A periodic specialist assessment can provide reassurance when everything is well and allow problems to be detected early when they are easier to manage. The message is simple: we have helped you grow up with a healthy heart; now we want to help you keep it healthy throughout adulthood.”
Dr. Minnie Bodhanwala, CEO, Bai Jerbai Wadia Hospital for Children, said, “Bai Jerbai Wadia Hospital for Children has a long-standing and comprehensive paediatric cardiac programme, and the Paediatric Cardiology Department currently treats more than 1,000 children every year. With major advances in diagnosis, cardiac surgery, catheter-based interventions, intensive care and neonatal care, an increasing proportion of children with congenital heart disease are now surviving well into adulthood. This has created an entirely new group of patients that are adults who have previously undergone surgery or interventions in childhood and now require specialised lifelong cardiac follow-up. We already see a significant number of patients who were treated for congenital heart disease during childhood and are now adults. However, 15-20 adult congenital patients are currently under follow-up.”
Dr. Minnie Bodhanwala concluded, “We therefore expect the clinic to progressively identify and bring back patients who require lifelong surveillance. These are children who survived because of advances in paediatric cardiac care. Now, as they grow into adults, it’s our responsibility to ensure that they do not fall through the gap between paediatric and adult medicine. This is the philosophy behind this initiative”.
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