Adult congenital cardiac interventional training, competencies, and organization. A Statement of the ESC ACHD Working Group, the EAPCI, the AEPC, and the PICS-Society

AIMS: The growing population of adults with congenital heart disease (ACHD) has prompted global initiatives to define standards of care, training pathways, and institutional requirements for catheter-based interventions. High-quality care and effective training rely on specialized, multidisciplinary centres integrating paediatric and adult cardiologists, surgeons, and anaesthesiologists with congenital expertise, supported by advanced catheter labs and hybrid theatres. This work outlines essential elements for optimal ACHD catheterization training, emphasizing a structured, competency-based curriculum covering theory, procedural skills, and post-procedural care. METHODS AND RESULTS: Collaboration between paediatric and adult cardiologists is highlighted as vital for comprehensive care. To meet national and regional needs, a two-tier model of 'level 1' and 'level 2' centres-each with specific capacities-is proposed. Scientific societies play a key role in establishing guidelines, certifications, and facilitating trainee mobility and international collaboration. Emerging tools such as augmented reality and virtual case libraries can improve accessibility and quality of training. The framework also addresses global equity, considering regional and socio-economic differences. Proctorships and partnerships with industry are integral for introducing innovations and maintaining skills in evolving techniques. CONCLUSION: By fostering collaboration, harmonized standards, and multidisciplinary expertise, this model aims to improve ACHD training and meet growing patient needs.