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Indian Guidelines for Indications and Timing of Intervention for Common Congenital Heart Diseases: Revised and Updated Consensus Statement of the Working Group on Management of Congenital Heart Diseases. Abridged Secondary Publication

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Abstract

Justification

A number of guidelines are available for management of congenital heart diseases from infancy to adult life. However, these guidelines are for patients living in high income countries. Separate guidelines, applicable to Indian children, are required when recommending an intervention for congenital heart diseases, as often these patients present late in the course of the disease and may have co-existing morbidities and malnutrition.

Process

Guidelines emerged following expert deliberations at the National Consensus Meeting on Management of Congenital Heart Diseases in India, held on 10th and 11th of August 2018 at the All India Institute of Medical Sciences, New Delhi. The meeting was supported by Children’s HeartLink, a non-governmental organization based in Minnesota, USA.

Objectives

To frame evidence based guidelines for (i) indications and optimal timing of intervention in common congenital heart diseases; (ii) follow-up protocols for patients who have undergone cardiac surgery/catheter interventions for congenital heart diseases.

Recommendations

Evidence based recommendations are provided for indications and timing of intervention in common congenital heart diseases, including left-to-right shunts (atrial septal defect, ventricular septal defect, atrioventricular septal defect, patent ductus arteriosus and others), obstructive lesions (pulmonary stenosis, aortic stenosis and coarctation of aorta) and cyanotic congenital heart diseases (tetralogy of Fallot, transposition of great arteries, univentricular hearts, total anomalous pulmonary venous connection, Ebstein anomaly and others). In addition, protocols for follow-up of post surgical patients are also described, disease wise.

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Funding

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Authors and Affiliations

  1. Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110 029, India

    Anita Saxena, Jay Relan, Velayoudam Devagourou, Saurabh K. Gupta, Shyam S. Kothari, Palleti Rajashekar, Sivasubramanian Ramakrishnan & Sachin Talwar

  2. Madras Medical Mission, Chennai, India

    Ravi Agarwal

  3. Max Super Speciality Hospital, New Delhi, India

    Neeraj Awasthy & Kulbhushan S. Dagar

  4. Fortis Escorts Heart Institute, New Delhi, India

    Sushil Azad, Krishna S. Iyer & S. Radhakrishnan

  5. Apollo Hospitals, New Delhi, India

    Manisha Chakrabarty & Vikas Kohli

  6. Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India

    Baiju S. Dharan & K. M. Krishnamoorthy

  7. Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India

    M. Jayranganath

  8. Sir Ganga Ram Hospital, New Delhi, India

    Raja Joshi

  9. Vadamalayan Hospitals, Madurai, Tamil Nadu, India

    B. R. J. Kannan

  10. Sri Sathya Sai Sanjeevani Hospital, Raipur, Chhattisgarh, India

    Ashish Katewa

  11. Care Hospital, Hyderabad, Telangana, India

    Nageswara Rao Koneti

  12. Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India

    Snehal Kulkarni, Smruti R. Mohanty & Suresh G. Rao

  13. Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Rohit Manoj Kumar

  14. Amrita Institute of Medical Sciences, Kochi, Kerala, India

    Raman Krishna Kumar

  15. Narayana Institute of Cardiac Sciences, Bangalore, Karnataka, India

    Sunita Maheshwari & Chinnaswamy H. M. Reddy

  16. Sri Sathya Sai Sanjeevani International Centre for Child Heart Care and Research, Palwal, Haryana, India

    Krishna Manohar

  17. Jaypee Hospital, Noida, Uttar Pradesh, India

    Ashutosh Marwah, Smita Mishra & Rajesh Sharma

  18. Innova Children’s Heart Hospital, Hyderabad, Telangana, India

    Kona Samba Murthy

  19. Narayana Hrudayalaya, Bangalore, Karnataka, India

    P. V. Suresh

  20. Star Hospital, Hyderabad, Telangana, India

    Nitin Rao

  21. HN Reliance Hospital, Mumbai, Maharashtra, India

    Krishnanaik Shivaprakasha

  22. Frontier Lifeline Hospital, Chennai, India

    Raghavan Subramanyan

  23. Believers International Heart Centre, Thiruvalla, Kerala, India

    R. Suresh Kumar

  24. Nutema Hospital, Meerut, Uttar Pradesh, India

    Munesh Tomar

  25. Krishna Institute of Medical Sciences, Secunderabad, Telangana, India

    Sudeep Verma

  26. GKNM Hospital, Coimbatore, Tamil Nadu, India

    Vijayakumar Raju

Authors
  1. Anita Saxena
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  2. Jay Relan
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  3. Ravi Agarwal
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  4. Neeraj Awasthy
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  5. Sushil Azad
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  6. Manisha Chakrabarty
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  7. Kulbhushan S. Dagar
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  8. Velayoudam Devagourou
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  9. Baiju S. Dharan
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  10. Saurabh K. Gupta
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  11. Krishna S. Iyer
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  12. M. Jayranganath
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  13. Raja Joshi
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  14. B. R. J. Kannan
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  15. Ashish Katewa
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  16. Vikas Kohli
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  17. Nageswara Rao Koneti
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  18. Shyam S. Kothari
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  19. K. M. Krishnamoorthy
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  20. Snehal Kulkarni
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  21. Rohit Manoj Kumar
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  22. Raman Krishna Kumar
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  23. Sunita Maheshwari
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  24. Krishna Manohar
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  25. Ashutosh Marwah
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  26. Smita Mishra
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  27. Smruti R. Mohanty
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  28. Kona Samba Murthy
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  29. P. V. Suresh
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  30. S. Radhakrishnan
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  31. Palleti Rajashekar
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  32. Sivasubramanian Ramakrishnan
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  33. Nitin Rao
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  34. Suresh G. Rao
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  35. Chinnaswamy H. M. Reddy
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  36. Rajesh Sharma
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  37. Krishnanaik Shivaprakasha
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  38. Raghavan Subramanyan
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  39. R. Suresh Kumar
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  40. Sachin Talwar
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  41. Munesh Tomar
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  42. Sudeep Verma
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  43. Vijayakumar Raju
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Consortia

Working group on Management of Congenital Heart Disease in India

Contributions

All authors were part of the National Consensus Meeting that formulated these Guidelines. All authors reviewed the literature and drafted recommendations of respective sections assigned to them. The final document was drafted and compiled by AS and JR. All authors provided critical inputs at every stage to finalize the draft recommendations. All authors approved the final document.

Corresponding author

Correspondence to Anita Saxena.

Additional information

Competing interest

None stated.

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Working group on Management of Congenital Heart Disease in India., Saxena, A., Relan, J. et al. Indian Guidelines for Indications and Timing of Intervention for Common Congenital Heart Diseases: Revised and Updated Consensus Statement of the Working Group on Management of Congenital Heart Diseases. Abridged Secondary Publication. Indian Pediatr 57, 143–157 (2020). https://doi.org/10.1007/s13312-020-1733-x

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  • DOI: https://doi.org/10.1007/s13312-020-1733-x

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