62
Specific Conditions
Table 31. Isolated Branch Pulmonary Artery 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
24–36 24
6–12
3–6
Electrocardiogram 24–36 24
12 12
Transthoracic
echocardiogram
24–36 24 12 12
For recommendations about timing of CT and MR angiography, see Section 4.3.4 supportive
text for recommendation #1.
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; CT, computed tomography; and MR, magnetic
resonance.
4.3.5. Tetralogy of Fallot
COR LOE
Recommendations
Diagnostic
1 B-NR
1. In adults with repaired TOF, echocardiography is
recommended for assessment of pulmonary and tricuspid
valve dysfunction, right atrial size, ventricular size and
function, residual VSDs, and estimation of RV systolic
pressure to characterize residual hemodynamic sequelae.
1 B-NR
2. In adults with repaired TOF and residual hemodynamic
sequelae, CMR imaging is recommended for quantifying
pulmonary valve function, ventricular size and function, and
branch PA size and flow; characterizing the right and LVOT
anatomy; quantifying residual shunts or aortopulmonary
collateral flow; and assessing fibrosis and viability of the
ventricular myocardium.
1 B-NR
3. In adults with repaired TOF undergoing right ventricle-
to-pulmonary artery (RV-to-PA) conduit stenting or
transcatheter pulmonary valve placement with a balloon-
expandable platform, assessment of coronary artery
compression risk is indicated to ensure absence of coronary
artery compression from stent/valve placement.
1 B-NR
4. In adults with repaired TOF and native RVOT anatomy
being considered for transcatheter pulmonary valve
replacement, cardiac CT is recommended to determine
anatomic suitability.
