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As we explained in our article, the option to acquire the additional qualification to treat adults with congenital heart defects is open to pediatric cardiologists as well as adult cardiologists. The treatment of and care for those patients undoubtedly requires the close cooperation of adult cardiologists and pediatric cardiologists in a defined structure, such as has been set out accordingly by the specialist societies in the criteria for centers treating adults with congenital heart defects and practices specializing in the subject. The “seamless transition” referred to such an institution, wherever it is based, taking over the care. In any case, pediatric and adult cardiological expertise should come together. Neither a pediatric cardiological institution nor one for adults meets the criteria of a center treating adults with congenital heart defects per se. For this reason, the process of certification of supraregional centers has been initiated by the specialist societies, verifying whether all conditions for the guideline conform care of adult patients with congenital heart defects are really met. Supraregional centers should function as part of a network with regional centers and cardiologists with the extra qualification.

Riedel is entirely correct that substantial problems are encountered in billing for the services of pediatric cardiologists who treat adult patients with congenital heart defects and the interdisciplinary task force was aware of those problems (1). Unfortunately, no consistent process is in sight. We hope this clarifies any misunderstandings.

DOI: 10.3238/arztebl.2012.0132b

Dr. Dr. med. Gerhard-Paul Diller

Prof. Dr.med. Dr. h.c. Günter Breithardt

Prof. Dr. med. Helmut Baumgartner

Kardiologisches Zentrum für Erwachsene mit

angeborenen (EMAH) und erworbenen Herzfehlern

Universitätsklinikum Münster

helmut.baumgartner@ukmuenster.de

Conflict of interest statement
The authors declare that no conflict of interest exists.

1.
Kaemmerer H, Breithardt G; Kommission für Klinische Kardiologie der Deutschen Gesellschaft für Kardiologie: Empfehlungen zur Qualitätsverbesserung der interdisziplinären Versorgung von Erwachsenen mit angeborenen Herzfehlern. Clin Res Cardiol 2006; 95 Suppl 4: 76–84 MEDLINE
2.
Diller GP, Breithardt G, Baumgartner H: Congenital heart defects in adulthood. Dtsch Arztebl Int 2011; 108(26): 452–9 VOLLTEXT
1. Kaemmerer H, Breithardt G; Kommission für Klinische Kardiologie der Deutschen Gesellschaft für Kardiologie: Empfehlungen zur Qualitätsverbesserung der interdisziplinären Versorgung von Erwachsenen mit angeborenen Herzfehlern. Clin Res Cardiol 2006; 95 Suppl 4: 76–84 MEDLINE
2.Diller GP, Breithardt G, Baumgartner H: Congenital heart defects in adulthood. Dtsch Arztebl Int 2011; 108(26): 452–9 VOLLTEXT