14
General Principles
3.4. Expertise for Cardiac Surgery and Invasive Cardiac
Procedures
COR LOE
Recommendations
1 B-NR
1. In patients with ACHD who undergo invasive cardiac
procedures, preprocedural involvement of an ACHD
cardiologist is recommended to risk-stratify the patient,
determine appropriate procedure location, guide
periprocedural planning and support, and assist in
preprocedural clinical optimization to improve outcomes.
1 B-NR
2. In patients with ACHD, invasive cardiac procedures
involving congenital lesions should be performed by
operators with expertise in congenital heart disease
procedures to ensure appropriate periprocedural care.
1 C-LD
3. In patients with ACHD undergoing invasive cardiac
procedures, postprocedural care should involve collaboration
with an ACHD cardiologist to incorporate expert opinion,
provide guideline-based therapy, and improve outcomes.
1 C-LD
4. In patients with ACHD AP classifications IC–D, IIA–D, and
IIIA–D, anesthesia for invasive cardiac procedures should be
administered by, or in collaboration or consultation with, an
anesthesiologist who has congenital heart disease expertise to
reduce the likelihood of perioperative complications.
2a B-NR
5. In patients with ACHD who undergo invasive cardiac
procedures for acquired cardiovascular disease, it can be
beneficial for operators with expertise in procedural treatment
of acquired disease to collaborate with ACHD experts.
