Consensus on timing of intervention for common congenital heart disease

Abstract

Justification: Separate guidelines are needed for determining the optimal timing of intervention in children with congenital heart diseases in India, because of their frequent late presentation, undernutrition and co-existing morbidities.

Process: Guidelines emerged following expert deliberations at the National Consensus Meeting on Management of Congenital Heart Diseases in India, held on 26th August 2007 at the All India Institute of Medical Sciences, New Delhi, India, supported by Cardiological Society of India.

Objectives: To frame evidence based guidelines for (i) appropriate timing of intervention in congenital heart diseases; (ii) assessment of operability in left to right shunt lesions; and (iii) prophylaxis of infective endocarditis in these children.

Recommendations: Evidence based recommendations are provided for timing of intervention in common congenital heart diseases including left to right shunt lesions (atrial septal defect, ventricular septal defect, patent ductus arteriosus and others); obstructive lesions (coarctation of aorta, aortic stenosis, pulmonary stenosis); and cyanotic defects (tetralogy of Fallot, transposition of great arteries, total anomalous pulmonary venous connection, truncus arteriosus). Guidelines are also given for assessment of operability in left to right shunt lesions and for infective endocarditis prophylaxis.