Cardiology Groups Release Updated Congenital Heart Disease Guidelines

By Jonathan Springston, Editor, Relias Media

Recognizing that multiple variables can affect how congenital heart disease affects specific patients, the American College of Cardiology and the American Heart Association have released new guidelines regarding individualized treatment of adults with the disease.

More than three dozen U.S. researchers and physicians updated congenital heart disease guidance that was first issued in 2008. Their goal was to create a more comprehensive treatment experience for these patients. Under this revised guidance, patients 17 years of age and older will receive diagnosis and follow-up care based on how congenital heart disease is progressing in each individual patient.

“We’ve accumulated enough data to be able to personalize care for patients in a sense to more closely categorize them and make follow-up recommendations and decisions based on a new set of categories,” Karen Stout, MD, FACC, chair of the writing committee for the guidelines and director of the Adult Congenital Heart Disease Program at University of Washington Medical Center, explained in a statement. “We’ve learned there are a lot of other variables. Just because someone has, for example, Tetralogy of Fallot or an atrial septal defect doesn’t mean they are the same as others with the same diagnoses.”

In the decade since the release of the first guidelines, there have been many advances in the diagnosis and treatment of congenital heart disease. The new guidelines recommend physicians consider both physiology and anatomy, rather than anatomy only, in their diagnostic and treatment approaches. Throughout the guidelines, the authors stress the importance of specialized care for congenital heart disease patients, noting patients who receive such care experience better outcomes. In general, the guideline authors updated these recommendations to help not only cardiologists but many other healthcare professionals, including primary care providers, surgeons, and pediatric clinicians.

"Patients with [advanced congenital heart disease] are a heterogeneous population," Stout said. "The population of patients with a given congenital abnormality or specific repair may be relatively small, which can make accruing evidence to guide treatment challenging. As new data become available, we expect changes to the relative weights attributed to the existing components of the classification system and perhaps new components, resulting in a system that ever more precisely tracks the overall severity of the patient's disease and need for more or less intensive follow-up and management."

For more about these new guidelines and much more cardiology research, be sure to check out issues of Clinical Cardiology Alert.