70
Specific Conditions
Table 34. Repaired Tetralogy of Fallot: 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
12–24 12–24
12
3–6
Electrocardiogram 24 12–24
12 12
Transthoracic
echocardiogram
24
12–24
12 6–12
For timing of routine CMR and cardiac CT, see Section 4.3.5 for recommendations #2–5.
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 congenial heart disease; CMR, cardiovascular magnetic resonance; and
CT, computed tomography.
4.3.6. Pulmonary Atresia With Intact Ventricular Septum
4.3.7. Management of Right Ventricle-to-Pulmonary Artery
Conduits
COR LOE
Recommendations
Diagnostic
1 B-NR
1. In patients undergoing RV-to-PA conduit stent implantation and/
or transcatheter pulmonary valve implantation, preprocedural
assessment of the risk for coronary artery compression should be
performed to prevent coronary artery obstruction.
1 B-NR
2. In patients with a stent implanted within an RV-to-PA conduit
who have unanticipated progression in conduit dysfunction,
imaging should be performed to rule out conduit stent fracture.
1 B-NR
3. In patients with an RV-to-PA conduit, with or without
transcatheter pulmonary valve implantation, unexpected
conduit dysfunction with worsening pulmonary stenosis or
pulmonary regurgitation should prompt an evaluation to rule
out infective endocarditis and/or thrombus.
2a C-LD
4. In adults with an RV-to-PA conduit and unexplained
sustained arrhythmia, heart failure symptoms, ventricular
dysfunction, or cyanosis, cardiac catheterization is reasonable
to assess the hemodynamics to guide further management.
2a C-LD
5. In adults with an RV-to-PA conduit being considered for
transcatheter intervention, preprocedural coronary CT is
reasonable to assess conduit calcification, anatomic characteristics,
and coronary artery proximity to guide procedural planning.
