The use of catheter intervention procedures for congenital heart disease

Abstract

Listen

Translate article

The pioneering proposals to use catheter procedures to treat congenital heart disease were published over 20 years ago (1-3). Only in the last half decade, however, have most of these procedures achieved sufficient clinical maturity to affect the delivery of cardiac care to children. In some centers, such procedures now constitu~e a large percentage of all cardiac catheterizations performed (Fig. 1). During the last 5 years, various workers have laid the experimental foundations for most of these transcatheter techniques. Others have described the initial clinical experiences for balloon angioplasty of pulmonary veins (4), pulmonary arteries (5), pulmonary valves (6), native (7) and recurrent (7,8) aortic coarctations, aortic valves (9) and obstructed intracardiac baffles (10). In addition to these balloon angioplasties and v;tlvuloplasties, other transcatheter techniques have been successfully applied to congenital heart disease, including knife atrial septostolllY (11), closure of the patent ductus arteriosus (12,13), closure of large systemic pulmonary artery vessels (14,15) and arteriovenous fistulas (16). As a group, these procedures are still too new to identify their indications and contraindications with any precision. Nonetheless, enough clinical experience has accrued to allow a discussion of how these techniques appear to fit into the current practice of pediatric cardiology at our own institution.