Saxena Anita, Relan Jay, Agarwal Ravi, Awasthy Neeraj, Azad Sushil, Chakrabarty Manisha, Dagar Kulbhushan S, Devagourou Velayoudam, Dharan Baiju S, Gupta Saurabh K, Iyer Krishna S, Jayranganath M, Joshi Raja, Kannan B R J, Katewa Ashish, Kohli Vikas, Koneti Nageswara Rao, Kothari Shyam S, Krishnamoorthy K M, Kulkarni Snehal, Kumar Rohit Manoj, Kumar Raman Krishna, Maheshwari Sunita, Manohar Krishna, Marwah Ashutosh, Mishra Smita, Mohanty Smruti R, Murthy Kona Samba, Suresh P V, Radhakrishnan S, Rajashekar Palleti, Ramakrishnan Sivasubramanian, Rao Nitin, Rao Suresh G, Reddy Chinnaswamy Hm, Sharma Rajesh, Shivaprakasha Krishnanaik, Subramanyan Raghavan, Kumar R Suresh, Talwar Sachin, Tomar Munesh, Verma Sudeep, Raju Vijayakumar
All India Institute of Medical Sciences, New Delhi, India. Correspondence to: Dr Anita Saxena, DM (Cardiology), Professor, Department of Cardiology, All India Institute of Medical Sciences, New Delhi 110 029, India.
All India Institute of Medical Sciences, New Delhi, India.
Indian Pediatr. 2020 Feb 15;57(2):143-157.
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.
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.
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.
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.
目前有许多关于先天性心脏病从婴儿期到成年期管理的指南。然而,这些指南是针对高收入国家的患者制定的。在为先天性心脏病推荐干预措施时,需要适用于印度儿童的单独指南,因为这些患者往往在疾病后期才就诊,可能并存其他疾病和营养不良。
这些指南是在2018年8月10日和11日于新德里全印度医学科学研究所举行的印度先天性心脏病管理全国共识会议上,经过专家审议后形成的。该会议得到了美国明尼苏达州一家非政府组织“儿童心脏连接”的支持。
制定基于证据的指南,用于(i)常见先天性心脏病干预的适应症和最佳时机;(ii)接受先天性心脏病心脏手术/导管介入治疗患者的随访方案。
针对常见先天性心脏病干预的适应症和时机提供了基于证据的建议,包括左向右分流(房间隔缺损、室间隔缺损、房室间隔缺损、动脉导管未闭等)、梗阻性病变(肺动脉狭窄、主动脉狭窄和主动脉缩窄)和青紫型先天性心脏病(法洛四联症、大动脉转位、单心室心脏、完全性肺静脉异位连接、埃布斯坦畸形等)。此外,还按疾病分类描述了术后患者的随访方案。