Adult Congenital Heart Service

The Adult Congenital Heart Disease fellowship program at Children?s Hospital aims to produce a highly trained cohort of ACHD specialists who are capable of assuming a leadership role in the creation of an integrated network of specialized centers. The Boston Adult Congenital Heart Disease (BACH) and Pulmonary Hypertension Service is an internationally recognized multi-departmental, multi-institutional clinical service that functions as a center of excellence for both adult congenital heart disease and pulmonary hypertensive disorders.

Our program involves Brigham and Women?s Hospital and Children?s Hospital Boston as the two primary institutions, and has strong ties with Massachusetts General Hospital and Beth Israel Deaconess Medical Center as well as developing affiliations with Boston Medical Center and the New England Medical Center.

The BACH service at Harvard Medical School actively follows more than 6,000 adult patients with both inpatient (approximately 35-45 patients per month) and outpatient (approximately 120 visits per month) services, accepting approximately 5-10 new referrals per week.

The patient base at Children?s Hospital and Brigham & Women?s Hospital represents one of the greatest strengths of the fellowship training program. It reflects the hospitals? long histories of leadership in caring for congenital and acquired heart disease, and includes large local, regional, national and international referral sources.

Our patients include many living here in New England as well as some who travel from as far away as Norway. In this way, our ACHD fellowship program provides world-class hands-on training in clinical skills, diagnosis, and management of the most complex of patients. To date, the BACH service has graduated over 25 full-time fellows.

While many of our fellows have benefited from previous training in combined internal medicine-pediatrics residency programs, this is not a requirement. However, depending on the individual applicant?s long-term goals, those with limited internal medicine or pediatrics exposure may be strongly urged to complete a 2-year ACHD fellowship.

The BACH ACHD fellowship curriculum is based largely upon recommendations set forth by the American College of Cardiology in the 1995 Recommendations for Training in Adult Cardiovascular Medicine Core Cardiology Training (COCATS) Task Force 9, the COCATS II revision in 2002, and the 32nd Bethesda Conference Task Force 31-3.

To date, there have been no formal recommendations for ACHD training in pediatric cardiology. Our fellows attend general ACHD clinic one day a week, medical/surgical conferences one day a week, and present at least four times a year at the weekly Brigham and Women?s cardiology conference.

Full-time BACH senior fellows are expected to provide at least six months of direct inpatient on-service time during the course of training, including inpatient responsibilities 18 weekends per year. For individuals with specific interests, there is potential for tailoring the curriculum to include emphasis on non-invasive imaging (echocardiography and/or MRI), interventional procedures, or electrophysiology. For trainees with limited or no background in internal medicine, additional exposure to primary prevention, coronary artery disease, and heart failure will be ensured. Similarly, those with limited background in pediatric cardiology will be presented with additional opportunities for acquiring familiarity with embryology and post-operative management.

BACH ARCHES (Adult Registry for Congenital Heart Evidence, Evaluation and Standards) is a data management and registry program designed to accurately and efficiently catalogue and assess BACH clinical, research, and financial activity, and to assay productivity and outcomes. Clinical research within the ARCHES program of BACH is an expected and necessary part of the BACH training program. Fellows are expected to bring a desire to further understand basic or clinical mechanisms of normalcy, disease, and health recovery in ACHD patients, and will be mentored to continue this pursuit of knowledge within their fellowship and future academic careers.

Interested individuals are invited to contact:
Anne Marie Valente, MD
Boston Adult Congenital Heart Group
? Department of Cardiology
Children?s Hospital Boston
ph. (617) 355-6508

Peter Lang, M.D
Director, Clinical Training Program
Department of Cardiology
Children's Hospital Boston
300 Longwood Avenue
Boston, MA 02115