The Society of Thoracic Surgeons/World Society for Pediatric and Congenital Heart Surgery/European Congenital Heart Surgeons Association 2026 Clinical Practice Guidelines on Indications and Timing of Pulmonary Valve Replacement in Repaired Tetralogy of Fallot.

Abstract

The Society of Thoracic Surgeons/World Society for Pediatric and Congenital Heart Surgery/European Congenital Heart Surgeons Association 2026 Clinical Practice Guidelines on Indications and Timing of Pulmonary Valve Replacement in Repaired Tetralogy of Fallot incorporate the most recent evidence for pulmonary valve replacement in this growing population. New evidence related to advanced imaging, electrophysiology testing, exercise testing, and transcatheter pulmonary valve replacement has emerged in the last 5 years. Compared with existing guidelines, the current update places emphasis on symptoms (children and adults), ventricular volumes (adults), and the need for invasive electrophysiology study before replacing the pulmonary valve (adults). This document is Part 1 and is accompanied by 2 other multisociety documents: Part 2: Society of Thoracic Surgeons/World Society for Pediatric and Congenital Heart Surgery/European Congenital Heart Surgeons Association 2026 Expert Consensus Document on Timing, Indications, and Options for Pulmonary Valve Replacement in Children with Repaired Tetralogy of Fallot, and Part 3: Society of Thoracic Surgeons/World Society for Pediatric and Congenital Heart Surgery/European Congenital Heart Surgeons Association 2026 Expert Opinion on the Role of Exercise Testing in Determining Optimal Timing of Pulmonary Valve Replacement in Tetralogy of Fallot. With this 3-part series, multidisciplinary team assessment, treatment planning, and long-term surveillance are also reinforced.