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Infants and children suffering from congenital heart disease represent a patient cohort particularly at risk for severe RSV infections. Most notably the complication rates in lower respiratory tract infections due to RSV among patients with congenital heart disease are significantly higher compared to other patient collectives. Predisposing factors are altered lung mechanics caused by either increased or decreased pulmonary blood flow, both resulting in a ventilation/ perfusion mismatch causing decreased pulmonary compliance and higher airway resistance. Randomized controlled trials have shown that immunoprophylaxis with palivizumab is beneficial for CHD patients. Guidelines from different national societies suggest administration of palivizumab for infants with CHD in young age injected monthly throughout the RSV season, if the CHD is considered hemodynamically significant.

Respiratory Syncytial Virus Infections among Children with Congenital Heart Disease