57
Table 28. Valvular Pulmonary Stenosis: Routine Follow-Up
and Testing Intervals
Type of Follow-Up
or Testing
Physiological
Stage A* (mo)
Physiological
Stage B* (mo)
Physiological
Stage C* (mo)
Physiological
Stage D* (mo)
Outpatient ACHD
cardiologist
36–60 24
6–12
3–6
Electrocardiogram 36–60 24
12 12
Transthoracic
echocardiogram
36–60 24 12 12
Modified with permission from Stout et al. Copyright © 2018 American Heart Association, Inc.
and American College of Cardiolog y Foundation.
* See Section 2.2 for details on the ACHD anatomic and physiological classification system.
ACHD indicates adult congenital heart disease.
4.3.2.1. Isolated Pulmonary Regurgitation After Repair of
Pulmonary Stenosis
COR LOE
Recommendations
Diagnostic
1 B-NR
1. In adults with moderate or greater pulmonary regurgitation
resulting from treated isolated valvular pulmonary stenosis,
CMR imaging is recommended to establish anatomy,
quantify the degree of regurgitation, and measure RV
volumes and systolic function.
erapeutic
1 B-NR
2. In patients with symptomatic moderate or greater pulmonary
regurgitation resulting from treated isolated valvular
pulmonary stenosis, pulmonary valve replacement is
recommended to improve symptoms.
2a C-LD
3. In asymptomatic patients with moderate or greater
pulmonary regurgitation resulting from treatment of isolated
pulmonary stenosis with RV systolic dysfunction, pulmonary
valve replacement is reasonable to restore valve function and
preserve RV systolic function.
2b C-LD
4. In asymptomatic patients who have moderate or greater
pulmonary regurgitation resulting from treatment of
isolated pulmonary stenosis and at least moderate tricuspid
regurgitation and/or progressive RV dilation or progressive
decline in exercise capacity,* pulmonary valve replacement
may be reasonable to restore valve function, ameliorate RV
size, and preserve RV systolic function.
* See Figure 5.
