Clinical Edge

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ACC/AHA Updates Guideline for Management of CHD

Circulation; ePub 2018 Aug 14; Stout, et al

Adults with congenital heart disease (CHD) may soon be treated with more personalized care, according to an updated guideline from the American College of Cardiology and the American Heart Association (ACC/AHA) for the management of adult congenital heart disease (ACHD) patients. The updated guideline establishes an anatomic and physiologic classification for patients with ACHD to better describe the clinical status, guide follow-up and therapeutic decisions, providing specific tables to help determine frequency and type of diagnostic testing. Among the guideline’s other highlights and recommendations:

  • The importance of transition from pediatric to ACHD care and the need to provide access and delivery of high quality lifelong specialized CHD care are described.
  • Women with CHD should receive pre-pregnancy counseling with input from an ACHD cardiologist to determine maternal cardiac, obstetrical, and fetal risks.
  • Recommendations for therapeutic intervention criteria and algorithms for shunt lesions are discussed.
  • Initial and follow-up aortic imaging is recommended in adults with coarctation of the aorta.
  • Primary prevention implantable cardioverter defibrillator (ICD) therapy for repaired Tetralogy of Fallot and patients with multiple risk factors for sudden cardiac death is recommended.


Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC guideline for the management of adults with congenital heart disease. [Published online ahead of print August 14, 2018]. Circulation. doi:10.1161/CIR.0000000000000603.