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Respiratory syncytial virus immunoprophylaxis for infants and young children with congenital heart disease*

Respiratory syncytial virus immunoprophylaxis for infants and young children with congenital heart disease*
Most likely to benefit from immunoprophylaxis:
Infants <12 months of age with acyanotic heart disease who are receiving medication to control heart failure and will require cardiac surgery
Infants <12 months of age with moderate to severe pulmonary hypertension
May benefit from immunoprophylaxis:
Infants <12 months of age with cyanotic heart disease
Children younger than 2 years who undergo cardiac transplantation during RSV season
Not indicated:
Children ≥12 months (with the exception of those <2 years undergoing cardiac transplantation during RSV season)
Infants <12 months with hemodynamically insignificant heart disease:
Secundum atrial septal defect
Small ventricular septal defect
Pulmonic stenosis
Uncomplicated aortic stenosis
Mild coarctation of the aorta
Patent ductus arteriosus
Infants <12 months of age with lesions adequately corrected by surgery unless they continue to require medication
Infants <12 months of age with mild cardiomyopathy who are not receiving medical therapy
RSV: respiratory syncytial virus.
* Palivizumab is the only RSV immunoprophylactic agent approved for infants with congenital heart disease. Decisions regarding RSV immunoprophylaxis for infants with congenital heart disease should be made in consultation with the infant's cardiologist.
Committee on Infectious Diseases and Bronchiolitis Guidelines Committee. Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics 2014; 134:415.
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