Table 7. Indications for ET in children and adolescents with valvular heart disease.

Indication	Class of recommendation	Level of evidence
In mild/moderate valvular heart disease, for assessment of symptoms, arrhythmias, cardiorespiratory fitness, and medical clearance/exercise prescription. 81 , 135	I	B
In AS, SVAS, and subaortic stenosis, for assessment of symptoms, risk stratification, and definition of interventional treatment. 81 , 134 , 136	IIa	B
In compensated, moderate to severe AI, for assessment of symptoms and cardiorespiratory fitness, indication of interventional treatment, and medical clearance/exercise prescription. 137 , 138	IIa	B
In bicuspid aortic valve, for assessment of the inotropic response and risk stratification. 62 , 139	IIa	B
After valve repair or replacement, for assessment of symptoms and cardiorespiratory fitness, prognosis, and medical clearance/exercise prescription. 140 , 141	IIa	B
Symptomatic patients with severe mitral or aortic stenosis, for assessment of cardiorespiratory fitness.	III	B

AI: aortic insufficiency; AS: aortic stenosis; SVAS: supravalvular aortic stenosis.