Document Overview

Document Title

Timing, Indications, and Options for Pulmonary Valve Replacement in Children with Repaired Tetralogy of Fallot

Authoring Societies

Society of Thoracic Surgeons

World Society for Pediatric and Congenital Heart Surgery

European Congenital Heart Surgeons Association

Document Publication Date

Jul 27, 2026

Page Last Reviewed/Updated

Jul 28, 2026

Document Type

Consensus Statement

Country of Publication

Global

Full Text Freely Available

No

Full Text Guideline

www.annalsthoracicsurgery.org/article/S0003-4975(26)00736-8/abstract

Source Citation

Stephens, Elizabeth H et al. “The 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.” The Annals of thoracic surgery, S0003-4975(26)00736-8. 27 Jul. 2026, doi:10.1016/j.athoracsur.2026.07.010

Document Scope, Criteria, and Use Cases

Document Objectives

Contemporary surgical and medical management has enabled excellent long-term survival and quality of life for children following repair of tetralogy of Fallot. However, most patients are left with residual pulmonary regurgitation that requires long-term surveillance and eventual pulmonary valve replacement to prevent right ventricular failure. Guidelines have been developed regarding the indications for and timing of pulmonary valve replacement in adults, but such do not exist for children. This expert consensus document aimed to address those gaps by supporting clinical decision-making regarding the surgical and transcatheter management of chronic pulmonary regurgitation in children with repaired tetralogy of Fallot. While decision-making regarding the management of chronic pulmonary regurgitation after repair of tetralogy of Fallot in children is complex, this document provides guidance for congenital heart teams to optimize management based on a synthesis of contemporary evidence.

Scope

Management, Treatment

Keywords

Pulmonary Valve Replacement, tetralogy of Fallot

Inclusion Criteria

Male, Female, Adolescent, Child

Health Care Settings

Ambulatory, Hospital, Operating and Recovery Room, Outpatient

Intended Users

Nurse, Nurse Practitioner, Physician, Physician Assistant