Canadian Cardiovascular Society 2022 Guidelines for Cardiovascular Interventions in Adults With Congenital Heart Disease

Ariane Marelli, Luc Beauchesne, Jack Colman, Robin Ducas, Jasmine Grewal, Michelle Keir, Paul Khairy, Erwin Oechslin, Judith Therrien, Isabelle F. Vonder Muhll, Rachel M. Wald, Candice Silversides, David J. Barron, Lee Benson, Pierre Luc Bernier, Eric Horlick, Réda Ibrahim, Giuseppe Martucci, Krishnakumar Nair, Nancy C. PoirierHeather J. Ross, Helmut Baumgartner, Curt J. Daniels, Michelle Gurvitz, Jolien W. Roos-Hesselink, Adrienne H. Kovacs, Christopher J. McLeod, Barbara J. Mulder, Carole A. Warnes, Gary D. Webb

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Interventions in adults with congenital heart disease (ACHD) focus on surgical and percutaneous interventions in light of rapidly evolving ACHD clinical practice. To bring rigour to our process and amplify the cumulative nature of evidence ACHD care we used the ADAPTE process; we systematically adjudicated, updated, and adapted existing guidelines by Canadian, American, and European cardiac societies from 2010 to 2020. We applied this to interventions related to right and left ventricular outflow obstruction, tetralogy of Fallot, coarctation, aortopathy associated with bicuspid aortic valve, atrioventricular canal defects, Ebstein anomaly, complete and congenitally corrected transposition, and patients with the Fontan operation. In addition to tables indexed to evidence, clinical flow diagrams are included for each lesion to facilitate a practical approach to clinical decision-making. Excluded are recommendations for pacemakers, defibrillators, and arrhythmia-directed interventions covered in separate designated documents. Similarly, where overlap occurs with other guidelines for valvular interventions, reference is made to parallel publications. There is a paucity of high-level quality of evidence in the form of randomized clinical trials to support guidelines in ACHD. We accounted for this in the wording of the strength of recommendations put forth by our national and international experts. As data grow on long-term follow-up, we expect that the evidence driving clinical practice will become increasingly granular. These recommendations are meant to be used to guide dialogue between clinicians, interventional cardiologists, surgeons, and patients making complex decisions relative to ACHD interventions.

Original languageEnglish (US)
JournalCanadian Journal of Cardiology
DOIs
StateAccepted/In press - 2022

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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