Adult Congenital Heart Disease Program Unites Disciplines for Better Patient Care

By Heather Lander

The landscape of congenital heart disease has shifted dramatically. Thanks to advances in neonatal and pediatric care, more than 90 percent of infants born with serious congenital defects now survive into adulthood. As a result, a new challenge has emerged: caring for these patients throughout their lifespan, as their hearts and overall health evolve.

Congenital heart lesions repaired in infancy or early childhood — especially when a cardiac valve is involved — often demand lifelong surveillance and, at times, additional interventions.

“These patients need expert follow-up and often more surgeries throughout life,” said Dr. Andrea Giulio Quarti. Meeting those needs requires a truly comprehensive adult congenital heart disease (ACHD) program — one that unites cardiology, imaging, electrophysiology, anesthesiology, maternal-fetal medicine, transplantation, social support and surgical expertise within a coordinated, patient-centered framework.

A unique home: congenital surgery inside an adult hospital

While many ACHD programs are nested in pediatric centers or affiliated children’s hospitals, Houston Methodist stands out. Since its founding, the program has operated within the DeBakey Heart & Vascular Center, a standalone adult hospital environment. This structure allows ACHD patients to navigate adult-medicine complications seamlessly (e.g., vascular disease, kidney disease, obstetrics, orthopedic, neurosurgery, general surgery) without fragmented handoffs.

In 2024, Houston Methodist’s ACHD program successfully renewed its Adult Congenital Heart Association (ACHA) accreditation as a Comprehensive Care Center. This recognition underscores the institution’s commitment to excellence in adult congenital care and validates that the infrastructure meets rigorous standards in care, patient outcomes and multidisciplinary integration.

Building a team, curriculum and culture

Quarti emphasized that building an Adult Congenital Heart Disease program is not just about doing operations. It is a long-term institutional investment. “This program requires specialists in congenital cardiology, imaging, sonography, anesthesia, Intensivists, OR staff, and social support, each with domain expertise. Losing one key congenital cardiologist, imagist, or social worker can strain the program’s continuity,” he said.

He is also establishing a digital architecture for learning: a multimedia “manual” in which each congenital lesion has an interactive chapter — anatomy, surgical video, imaging, decision algorithms — that users can click through. Many of these modules already exist on the CV DeBakey Education platform; his goal is to organize and expand them as a complete curriculum.

Complementing that, he plans a monthly whiteboard surgical conference (webcast to Houston Methodist media channels) to walk through anatomy, surgical challenges and proposed solutions. The first Monday of each month has become a recurring forum for case-based education.

A central pillar of the program’s innovation lies in its use of 3D printing and virtual-reality surgical rehearsal, powered by collaboration with the Houston Methodist Institute for Technology, Innovation & Education (MITIE) at the Bookout Center. There, Quarti’s team converts patient CT scans into soft, pliable heart models that allow surgeons to practice procedures ex vivo and use immersive VR platforms to “walk through” the heart, inspect lesions from multiple angles, plan incisions and rehearse complex steps before entering the operating room. They also perform pig-heart simulations that closely mimic patient anatomy. Each year, the team focuses on a signature lesion — partial anomalous pulmonary venous return in 2024, tetralogy of Fallot in 2025, and aortic root surgery planned for 2026 — steadily expanding the program’s multimodal approach to surgical precision and education.

Transplant, network and reach

Beyond repair, Quarti also leads congenital transplant — even multi-organ transplants in congenital contexts. He noted that in one recent year, “100 percent of the heart and double lung transplants were done in congenital patients.” He also shared that congenital cardiac surgeons often collaborate with liver, lung, and general surgeons for combined heart/kidney or heart/liver transplants in cases of systemic failure, reinforcing the importance of program breadth.

Quarti’s reach is regional, and he accepts referrals from other states and is actively building a satellite network of referring hospitals to expand access. His vision is for Houston Methodist to become a hub, with outreach nodes upstream. In the long term, he aims not merely to do surgery but to elevate the specialty itself. He cautions that congenital cardiac surgery is “a specialty that is going to disappear” unless deliberately cultivated. The training path is long and demanding, with years of general and cardiac surgery before reaching the congenital subspecialty, and is far less direct than in other surgical careers.

Why this matters across disciplines

For surgeons, cardiologists and researchers alike, the ACHD program is a case study in institutional transformation. It illustrates how a hospital can invest in subspecialty depth, unify multidisciplinary services, embed innovation (3D, VR, simulation), and build a scholarly infrastructure (interactive curriculum, lectures), all while delivering high-stakes clinical care.

For the rest of us, the story is compelling: a rare disease population that once drifted in adult care silos now has access to an integrated center dedicated to lifelong congenital care.

In many ways, Quarti’s mission at Houston Methodist captures the future of complex cardiovascular medicine — one that spans decades, bridges pediatric and adult domains, and harnesses technology and teamwork to deliver better outcomes for patients with congenital heart disease, not just in childhood, but for life.