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Indian guidelines for indications and timing of intervention for common congenital heart diseases: Revised and updated consensus statement of the Working group on management of congenital heart diseases


1 Convener, All India Institute of Medical Sciences, New Delhi, India
2 Writing Committee, All India Institute of Medical Sciences, New Delhi, India
3 Madras Medical Mission, Chennai, India
4 Max Super Speciality Hospital, New Delhi, India
5 Fortis Escorts Heart Institute, New Delhi, India
6 Apollo Hospitals, New Delhi, India
7 All India Institute of Medical Sciences, New Delhi, India
8 Sree Chitra Tirunal Institute for Medical sciences and Technology, Trivandrum, Kerala, India
9 Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
10 Sir Ganga Ram Hospital, New Delhi, India
11 Vadamalayan Hospitals, Madurai, Tamil Nadu, India
12 Sri Sathya Sai Sanjeevani Hospital, Raipur, Chhattisgarh, India
13 Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
14 Postgraduate Institute of Medical Education and Research, Chandigarh, India
15 Amrita Institute of Medical Sciences, Kochi, Kerala, India
16 Narayana Institute of Cardiac Sciences, Bangalore, Karnataka, India
17 Sri Sathya Sai Sanjeevani International Centre for Child Heart Care and Research, Palwal, Haryana, India
18 Jaypee Hospital, Noida, Uttar Pradesh, India
19 Innova Children's Heart Hospital, Hyderabad, Telangana, India
20 Care Hospital, Hyderabad, Telangana, India
21 Narayana Hrudayalaya, Bangalore, Karnataka, India
22 Star Hospital, Hyderabad, Telangana, India
23 H.N. Reliance Hospital, Mumbai, Maharashtra, India
24 Frontier Lifeline Hospital, Chennai, India
25 Believers International Heart Centre, Thiruvalla, Kerala, India
26 Nutema Hospital, Meerut, Uttar Pradesh, India
27 Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
28 GKNM Hospital, Coimbatore, Tamil Nadu, India

Correspondence Address:
Prof. Anita Saxena
Department of Cardiology, All India Institute of Medical Sciences, New Delhi - 110 029
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.APC_32_19

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Year : 2019  |  Volume : 12  |  Issue : 3  |  Page : 254-286

 

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A number of guidelines are available for the management of congenital heart diseases (CHD) from infancy to adult life. However, these guidelines are for patients living in high-income countries. Separate guidelines, applicable to Indian children, are required when recommending an intervention for CHD, as often these patients present late in the course of the disease and may have coexisting morbidities and malnutrition. Guidelines emerged following expert deliberations at the National Consensus Meeting on Management of Congenital Heart Diseases in India, held on August 10 and 11, 2018, at the All India Institute of Medical Sciences. The meeting was supported by Children's HeartLink, a nongovernmental organization based in Minnesota, USA. The aim of the study was to frame evidence-based guidelines for (i) indications and optimal timing of intervention in common CHD; (ii) follow-up protocols for patients who have undergone cardiac surgery/catheter interventions for CHD; and (iii) indications for use of pacemakers in children. Evidence-based recommendations are provided for indications and timing of intervention in common CHD, including left-to-right shunts (atrial septal defect, ventricular septal defect, atrioventricular septal defect, patent ductus arteriosus, and others), obstructive lesions (pulmonary stenosis, aortic stenosis, and coarctation of aorta), and cyanotic CHD (tetralogy of Fallot, transposition of great arteries, univentricular hearts, total anomalous pulmonary venous connection, Ebstein's anomaly, and others). In addition, protocols for follow-up of postsurgical patients are also described, disease wise. Guidelines are also given on indications for implantation of permanent pacemakers in children.






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1 Convener, All India Institute of Medical Sciences, New Delhi, India
2 Writing Committee, All India Institute of Medical Sciences, New Delhi, India
3 Madras Medical Mission, Chennai, India
4 Max Super Speciality Hospital, New Delhi, India
5 Fortis Escorts Heart Institute, New Delhi, India
6 Apollo Hospitals, New Delhi, India
7 All India Institute of Medical Sciences, New Delhi, India
8 Sree Chitra Tirunal Institute for Medical sciences and Technology, Trivandrum, Kerala, India
9 Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
10 Sir Ganga Ram Hospital, New Delhi, India
11 Vadamalayan Hospitals, Madurai, Tamil Nadu, India
12 Sri Sathya Sai Sanjeevani Hospital, Raipur, Chhattisgarh, India
13 Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
14 Postgraduate Institute of Medical Education and Research, Chandigarh, India
15 Amrita Institute of Medical Sciences, Kochi, Kerala, India
16 Narayana Institute of Cardiac Sciences, Bangalore, Karnataka, India
17 Sri Sathya Sai Sanjeevani International Centre for Child Heart Care and Research, Palwal, Haryana, India
18 Jaypee Hospital, Noida, Uttar Pradesh, India
19 Innova Children's Heart Hospital, Hyderabad, Telangana, India
20 Care Hospital, Hyderabad, Telangana, India
21 Narayana Hrudayalaya, Bangalore, Karnataka, India
22 Star Hospital, Hyderabad, Telangana, India
23 H.N. Reliance Hospital, Mumbai, Maharashtra, India
24 Frontier Lifeline Hospital, Chennai, India
25 Believers International Heart Centre, Thiruvalla, Kerala, India
26 Nutema Hospital, Meerut, Uttar Pradesh, India
27 Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
28 GKNM Hospital, Coimbatore, Tamil Nadu, India

Correspondence Address:
Prof. Anita Saxena
Department of Cardiology, All India Institute of Medical Sciences, New Delhi - 110 029
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.APC_32_19

Rights and Permissions

A number of guidelines are available for the management of congenital heart diseases (CHD) from infancy to adult life. However, these guidelines are for patients living in high-income countries. Separate guidelines, applicable to Indian children, are required when recommending an intervention for CHD, as often these patients present late in the course of the disease and may have coexisting morbidities and malnutrition. Guidelines emerged following expert deliberations at the National Consensus Meeting on Management of Congenital Heart Diseases in India, held on August 10 and 11, 2018, at the All India Institute of Medical Sciences. The meeting was supported by Children's HeartLink, a nongovernmental organization based in Minnesota, USA. The aim of the study was to frame evidence-based guidelines for (i) indications and optimal timing of intervention in common CHD; (ii) follow-up protocols for patients who have undergone cardiac surgery/catheter interventions for CHD; and (iii) indications for use of pacemakers in children. Evidence-based recommendations are provided for indications and timing of intervention in common CHD, including left-to-right shunts (atrial septal defect, ventricular septal defect, atrioventricular septal defect, patent ductus arteriosus, and others), obstructive lesions (pulmonary stenosis, aortic stenosis, and coarctation of aorta), and cyanotic CHD (tetralogy of Fallot, transposition of great arteries, univentricular hearts, total anomalous pulmonary venous connection, Ebstein's anomaly, and others). In addition, protocols for follow-up of postsurgical patients are also described, disease wise. Guidelines are also given on indications for implantation of permanent pacemakers in children.






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