APPENDICES

APPENDIX I

Types of Patients who may be cared for Exclusively in the Community

Valves:

• Isolated aortic valve disease
• Isolated mitral valve disease (except parachute mitral valve and similar anomalies)
• Mild pulmonic valve stenosis
• Isolated tricuspid valve disease (except Ebstein anomaly)

Shunts:

• Secundum atrial septal defect (closed, no residual shunt, no arrhythmia, no pulmonary hypertension))
• Ductus arteriosus after complete closure with no residua
• Ventricular septal defect (small and isolated, or repaired with no residual lesions)
• Repaired partial anomalous pulmonary venous connection

 
APPENDIX II

Types of Patients who Should be Seen at National or Regional ACHD Centres (Alphabetical)

• Aorto-left ventricular fistula
  
• Atrioventricular septal defects
  
• Coarctation of the aorta
  
• Complete transposition of the great arteries
  
• Congenitally corrected transposition of the great arteries
  
• Coronary artery anomalies (except incidental findings)
  
• Criss-cross heart
  
• Cyanotic congenital heart patients (All)
  
• Double outlet ventricle
  
• Ebstein anomaly
  
• Eisenmenger syndrome
  
• Fontan procedure
  
• Heterotaxy syndromes
  
• Infundibular right ventricular outflow obstruction of significance
  
• Mitral atresia
  
• One ventricle (also called double inlet, double outlet, common, single, primitive)
  
• Partial anomalous pulmonary venous connection
  
• Patent ductus arteriosus (not closed)
  
• Pulmonary atresia (all forms)
  
• Pulmonary hypertension complicating CHD
  
• Pulmonic valve regurgitation (moderate or greater)
  
• Pulmonic valve stenosis (moderate to severe)
  
• Pulmonary vascular obstructive disease
  
• Sinus of Valsalva fistula/aneurysm
  
• Subvalvar or supravalvar aortic stenosis
  
• Tetralogy of Fallot
• Total anomalous pulmonary venous connection
• Tricuspid atresia
• Truncus arteriosus or Hemi-truncus
• Valved conduits
• Ventricular septal defect with:
  • Absent valves
  • Aortic regurgitation
  • Aortic coarctation
  • Mitral disease
  • Right ventricular outflow tract obstruction
  • Straddling tricuspid and/or mitral valve
  • Subaortic stenosis

 
APPENDIX III

Level of Evidence	Grade of Recommendation
Level I: Large randomized trials with clear-cut results, and low risk of error	A
Level II: Randomized trials with uncertain results and/or moderate to high risk of error	B
Level III: Nonrandomized studies with contemporaneous controls	C
Level IV: Nonrandomized studies with historical controls	C
Level V: Case series without controls	C

 
APPENDIX IV

UNIVERSITY/CENTRE	LOCATION	CONTACT PERSON
Memorial University	St. John's, NF	Dr. Anne Williams
Dalhousie University	Halifax, NS	Dr. Catherine Kells
Laval University	Ste-Foy, PQ	Dr. Marie-Helene Leblanc
McGill University	Montreal, PQ	Dr. Francois Marcotte
University of Montreal	Montreal, PQ	Dr. Annie Dore
Queen's University	Kingston, ON	Dr. Gary Burggraf
University of Ottawa	Ottawa, ON	Dr. Kwan Chan
University of Toronto	Toronto, ON	Dr. Gary Webb
McMaster University	Hamilton, ON	Dr. Elaine Gordon
University of Western Ontario	London, ON	Dr. Lynn Bergin
University of Manitoba	Winnipeg, MB	Dr. James Tam
University of Saskatchewan	Saskatoon, SK	Dr. James McMeekin
University of Calgary	Calgary, AB	Dr. Nanette Alvarez
University of Alberta	Edmonton, AB	Dr. Dylan Taylor
University of British Columbia	Vancouver, BC	Dr. Marla Kiess

 
APPENDIX V

ABBREVIATIONS USED IN THE TEXT

ACHD	adult congenital heart disease
ASD	atrial septal defect
AV	atrioventricular
AVSD	atrioventricular septal defect
CACH	Canadian Adult Congenital Heart [Network]
CBC	complete blood count
Cath	Catheterization
CCS	Canadian Cardiovascular Society
CHD	congenital heart disease
CT	computed tomography
ECG	Electrocardiogram
EPS	electrophysiologic study
ICU	intensive care unit
LV	left ventricle
LVOTO	left ventricular outflow tract obstruction
MRI	magnetic resonance imaging
NYHA	New York Heart Association
PA	pulmonary artery
PAP	pulmonary artery pressure
PDA	patent ductus arteriosus
PFO	patent foramen ovale
PHT	Pulmonary hypertension
PLE	protein-losing enteropathy
PS	pulmonary stenosis
Qp	pulmonary blood flow
Qs	systemic blood flow
RV	right ventricle
RVOT	right ventricular outflow tract
RVOTO	right ventricular outflow tract obstruction
SABP	systemic arterial blood pressure
SVC	superior vena cava
TEE	transesophageal echocardiogram
TIA	transient ischemic attack
TTE	transthoracic echocardiogram
TV	tricuspid valve
VSD	ventricular septal defect

 
APPENDIX VI

SHUNTS (Palliative surgical interventions to increase pulmonary blood flow)

Systemic Venous-to-Pulmonary Artery Shunts

Classic Glenn	SVC to right PA
Bi-directional Glenn	SVC to right and left PA
Bilateral Glenn	Right and left SVC to right and left PA respectively

Systemic Arterial-to-Pulmonary Artery Shunts

Classic Blalock-Taussig	Subclavian artery to ipsilateral PA (end-to-side)
Modified Blalock-Taussig	Subclavian artery to ipsilateral PA (prosthetic graft)
Potts' Anastomosis	Descending aorta to left PA
Waterston Shunt	Ascending aorta to right PA