Preamble
Introduction
- Why do we need new Guidelines on the management of adult congenital heart disease?
- Content of these Guidelines
- New format of the Guidelines
- How to use these Guidelines
- What is new in the 2020 Guidelines?
General aspects
- Prevalence of adult congenital heart disease
- Organization of care
- Diagnostic work-up
- Echocardiography
- Cardiovascular magnetic resonance imaging
- Cardiovascular computed tomography
- Cardiopulmonary exercise testing
- Cardiac catheterization
- Biomarkers
- Therapeutic considerations
- Heart failure
- Arrhythmias and sudden cardiac death
- Pulmonary hypertension
- Surgical treatment
- Catheter intervention
- Infective endocarditis
- Antithrombotic treatment
- Management of cyanotic patients
- Additional considerations
- Sex differences
- Adult congenital heart disease at more advanced age
- Advance care planning and end-of-life care
- Insurance and employment
- Exercise and sports
- Non-cardiac surgery
- Pregnancy, contraception, and genetic counselling
Specific lesions
- Atrial septal defect and anomalous pulmonary venous connection
- Introduction and background
- Clinical presentation and natural history
- Diagnostic work-up
- Surgical/catheter interventional treatment
- Specific aspects of isolated anomalous pulmonary venous connections
- Follow-up recommendations
- Additional considerations
- Ventricular septal defect
- Introduction and background
- Clinical presentation and natural history
- Diagnostic work-up
- Surgical/catheter interventional treatment
- Follow-up recommendations
- Additional considerations
- Atrioventricular septal defect
- Introduction and background
- Clinical presentation and natural history
- Diagnostic work-up
- Surgical/catheter interventional treatment
- Follow-up recommendations
- Additional considerations
- Patent ductus arteriosus
- Introduction and background
- Clinical presentation and natural history
- Diagnostic work-up
- Surgical/catheter interventional treatment
- Follow-up recommendations
- Additional considerations
- Left ventricular outflow tract obstruction
- Valvular aortic stenosis
- Supravalvular aortic stenosis
- Subaortic stenosis
- Coarctation of the aorta
- Introduction and background
- Clinical presentation and natural history
- Diagnostic work-up
- Surgical/catheter interventional treatment
- Follow-up recommendations
- Additional considerations
- Aortopathies
- Marfan syndrome and related heritable thoracic aortic diseases
- Bicuspid aortic disease
- Turner syndrome
- Right ventricular outflow tract obstruction
- Introduction and background 46
- Clinical presentation and natural history
- Diagnostic work-up
- Surgical/catheter interventional treatment
- Follow-up recommendations
- Additional considerations
- Ebstein anomaly
- Introduction and background
- Clinical presentation and natural history
- Diagnostic work-up
- Surgical/catheter interventional treatment
- Follow-up recommendations
- Additional considerations
- Tetralogy of Fallot
- Introduction and background
- Clinical presentation and natural history
- Diagnostic work-up of repaired patients
- Late surgical/catheter interventional treatment
- Indications for electrophysiological testing & implantable cardio defibrillator
- Follow-up recommendations
- Additional considerations
- Pulmonary atresia with ventricular septal defect
- Introduction and background
- Clinical presentation and natural history
- Diagnostic work-up
- Surgical/catheter interventional treatment
- Follow-up recommendations
- Additional considerations
- Transposition of the great arteries
- Introduction and background
- Atrial switch operation
- Arterial switch operation
- Rastelli-type operation
- Follow-up recommendations (irrespective of type of repair)
- Additional considerations (irrespective of type of repair)
- Congenitally corrected transposition of the great arteries
- Introduction and background
- Clinical presentation and natural history
- Diagnostic work-up
- Medical treatment
- Surgical/catheter interventional treatment
- Follow-up recommendations
- Additional considerations
- Right ventricular to pulmonary artery conduit
- Introduction and background
- Diagnostic work-up
- Surgical/catheter interventional treatment
- Follow-up recommendations
- Additional considerations
- Univentricular heart
- Introduction and background
- Clinical presentation and natural history
- Diagnostic work-up
- Conservative management
- Follow-up recommendations
- Additional considerations
- Patients after Fontan operation
- Introduction and background
- Clinical presentation and natural history
- Diagnostic work-up
- Medical treatment
- Surgical/interventional treatment
- Follow-up recommendations
- Additional considerations
- Coronary anomalies
- Introduction and background
- Diagnostic evaluation
- Surgical treatment
Quality Indicators
Gaps in evidence
- General aspects
- Organization of care and patient evaluation
- Heart failure
- Arrhythmia
- Pulmonary arterial hypertension
- Cyanotic patients
- Specific lesions
- Shunt lesions
- Left ventricular outflow tract obstruction & coarctation
- Aortopathies
- Right ventricular outflow tract obstruction
- Ebstein anomaly
- Tetralogy of Fallot
- Transposition of the great arteries
- Congenitally corrected transposition of the great arteries
- Univentricular heart and Fontan operation
- Coronary anomalies
Key messages
- General aspects
- Organization of care and patient evaluation
- Heart failure
- Arrhythmia
- Pulmonary arterial hypertension
- Cyanotic patients
- Specific lesions
- Shunt lesions
- Left ventricular outflow tract obstruction
- Aortic coarctation
- Aortopathies
- Right ventricular outflow tract obstruction
- Ebstein anomaly
- Tetralogy of Fallot
- Transposition of the great arteries
- Congenitally corrected transposition of the great arteries
- Univentricular heart and Fontan operation
- Coronary anomalies
‘What to do’ and ‘what not to do’ messages
Appendix
References