Interventional catheterization in congenital heart disease.

Abstract

Balloon dilation is now an established treatment for many congenital heart defects. Recent papers deal with the extension of this approach to more complex anomalies, such as tetralogy of Fallot and transposition of the great arteries; the results are variable. Another area of investigation is balloon valvoplasty in more contentious settings, such as neonatal aortic stenosis. The catheter method appears to be as effective as surgery in these cases. Attention has also been directed to the determinants of success or failure in, for example, aortic recoarctation. Here, as in aortic stenosis, basic anatomy plays an important role. Catheter closure procedures also figure in the literature. Closure of persistent ductus now appears to be established everywhere except in the United States. Also of interest are early reports of the "button device" for closure of atrial septal defects. The use of stents appears to offer effective treatment for peripheral pulmonary stenosis, a condition with disappointing results from surgery and balloon angioplasty. Stents may also offer an alternative method for long-term maintenance of duct patency. Catheter interventions now constitute a major part of the work of pediatric cardiologists, and the present status has been summarized in the past year.