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Management of Adults With Congenital Heart Disease

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24 General Principles 3.9. Ionizing Radiation Exposure COR LOE Recommendation 1 B-NR 1. In adults with congenital heart disease, processes to limit radiation exposure during imaging and cardiovascular procedures are recommended to reduce the lifetime risk for cancer. Table 10. Congenital Heart Conditions Considered Significantly High Risk for Maternal Complications in Pregnancy* Congenital Heart Lesions Severe, symptomatic, le-sided obstructive lesions (mitral stenosis, subaortic and aortic stenosis) Severe native coarctation or recoarctation Cyanotic congenital heart disease or Eisenmenger syndrome Fontan physiolog y Systemic right ventricle with at least moderately depressed ventricular function Other Factors/Conditions Advanced New York Heart Association class (III or IV) Prior adverse cardiac event during pregnancy Pulmonary arterial hypertension Significantly decreased systemic ventricular dysfunction (ejection fraction <30%) Aortopathy (diameter >5 cm or associated with connective tissue disorders) Mechanical heart valves Refractory ventricular arrhythmias Adapted from Regitz-Zagrosek et al, by permission of Oxford University Press. Copyright © 2018 e European Society of Cardiolog y and e European Society of Hypertension. * Information adapted from the modified World Health Organization classification system.

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