Thorac Cardiovasc Surg 2000; 48(6): 319-322
DOI: 10.1055/s-2000-8341
Original Cardiovascular
Original Paper
© Georg Thieme Verlag Stuttgart · New York

Interventional Catheterization in Surgically Treated Patients with Congenital Heart Disease

B. Friedli, I. Oberhänsli, B. Faidutti
  • Paediatric Cardiac unit, Department of Paediatrics Faculty of Medicine Geneva, Switzerland
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Interventional catheterization is an alternative to surgery for some congenital heart defects. For other malformations, the surgeon and the interventionist will join in an effort to obtain an optimal result: the typical example is pulmonary atresia with VSD and aortopulmonary collaterals. In other cases, the cardiologist may be called upon to intervene with catheter techniques to correct sequelae or residual lesions after surgical correction, avoiding redo surgery. Most often, the task consists of opening stenoses by balloon dilatation and/or stenting the main targets being pulmonary artery branch stenoses, venous obstructions after Mustard procedure, and recoarctations. Whereas simple balloon dilatation of recoarctation often brings good results, stents are often needed to obtain optimal results in pulmonary branch stenoses. Stenting of pulmonary veins has been disappointing. Closing unwanted vessels and defects is another task for the interventional cardiologist after cardiac surgery. Here, the most frequent procedure is closing aortopulmonary collaterals in pulmonary atresia and VSD after corrective surgery. Advantages and limitations of these procedures are discussed.

References

  • 1 Chatelain P, Meier B, Friedli B. Stenting of superior vena cava and inferior vena cava for symptomatic narrowing after repeated atrial surgery for D-transposition of the great vessels.  Brit Heart J. 1991;  66 466-468
  • 2 Ward C JB, Mullins C E, Nihill M R, Grifka R G, Vick W. Use of intravascular stents in systemic venous and systemic venous baffle obstructions: short term follow-up results.  Circulation. 1995;  91 2948-2954
  • 3 Shaffer K M, Mullins C E, Grifka R G, O'Laughlin M R, Mcmahon W, Ing F F, Nihill M R. Intravascular stents in congenital heart disease: short- and long-term results from a large single-center experience.  J Am Coll Cardiol. 1998;  31 661-667
  • 4 Powell A J, Lock J E, Keane J F, Perry S B. Prolongation of RV-PA conduit life span by percutaneous stent implantation. Intermediate-term results.  Circulation. 1995;  92 3282-3288
  • 5 Nakanishi T, Matsumoto Y, Seguchi M, Nazakawa M, Imai Y, Momma K. Balloon angioplasty for postoperative pulmonary artery stenosis in transposition of the great arteries.  J Am Coll Cardiol. 1993;  22 859-866
  • 6 Hosking M CK, Thomaidis C, Hamilton R, Burrows P E, Freedom R M, Benson L N. Clinical impact of balloon angioplasty for branch pulmonary arterial stenosis.  Am J Cardiol. 1992;  69 1467-1470
  • 7 Worms A M, Marcon F, Pernot C. Angioplastie transluminale percutanée de sténoses des branches artérielles pulmonaires après correction chirurgicale de tétralogie de Fallot.  Arch Mal Coeur. 1989 ;  82 701-706
  • 8 Gentles T L, Lock J E, Perry S B. High pressure balloon angioplasty for branch pulmonary artery stenosis: early experience.  J Am Coll Cardiol. 1993;  22 867-872
  • 9 Fogelman R, Nykanen D, Smallhorn J F, McCrindle B W, Freedom R M, Benson L N. Endovascular stents in the pulmonary circulation.  Circulation. 1995;  92 881-885
  • 10 Hosking M CK, Benson L N, Nakanishi T, Burrows P E, Williams W G, Freedom R M. Intravascular stent prosthesis for right ventricular outflow obstruction.  J Am Coll Cardiol. 1992;  2 373-380
  • 11 O'Laughlin M P, Slack M C, Grifka R G, Perry S B, Lock J E, Mullins C E. Implantation and intermediate-term follow-up of stents in congenital heart disease.  Circulation. 1993;  88 605-614
  • 12 Mendelsohn A M, Bove E L, Lupinetti F M, Crowley D C, Lloyd T R, Fedderly R T, Beekman R H. Intraoperative and percutaneous stenting of congenital pulmonary artery and vein stenosis.  Circulation. 1993;  88/2 210-217
  • 13 Sohn S, Roghman A, Shiota T, Luk G, Tong A, Swensson R E, Sahn D J. Acute and follow-up intravascular ultrasound findings after balloon dilation of coarctation of the aorta.  Circulation. 1994;  9 340-347
  • 14 McCrindle B W, Jones T K, Morrow W R, Hagler D J, Lloyd T R, Nouri S, Latson L A. Acute results of balloon angioplasty of native coarctation versus recurrent aortic obstruction are equivalent.  J Am Coll Cardiol. 1996;  28 1810-1817
  • 15 Suarez De Lezo J, Pan M, Romero M, Medina A, Segura J, Lafuente M, Pavlovic D, Hernandez E, Melian F, Espada J. Immediate and follow-up findings after stent treatment for severe coarctation of aorta.  Am J Cardiol. 1999;  83 400-406
  • 16 Ebeid M R, Prieto L R, Latson L A. Use of balloon-expandable stents for coarctation of the aorta: initial results and intermediate-term follow-up.  J Am Coll Cardiol. 1997;  3 1847-1852
  • 17 Marx G R, Allen H D, Ovitt T W, Hanson W. Balloon dilation angioplasty of Blalock-Taussig Shunts.  Am J Cardiol. 1988;  62 824-827
  • 18 Zahn E M, Lima V C, Benson L N, Freedom R M. Use of endovascular stents to increase pulmonary blood flow in pulmonary atresia with ventricular septal defect.  Am J Cardiol. 1992;  7 411
  • 19 Redington A N, Somerville J. Stenting of aortopulmonary collaterals in complex pulmonary atresia.  Circulation. 1996;  94 2479-2484
  • 20 Hijazi Z M., Fahey J T, Kleinman C S, Kopf G S, Hellenbrand W E. Hemodynamic evaluation before and after closure of fenestrated Fontan: an acute study of changes in oxygen delivery.  Circulation. 1992;  86 196-202
  • 21 Bridges N D, Mayer J E, Lock J E, Jonas R A, Hanley F L, Keane J F, Perry S B, Castaneda A R. Address for correspondence and reprints: Effect of baffle fenestration on outcome of the modified Fontan operation.  Circulation. 1992;  86 1762-1769

Béat Friedli, MD 

Hôpital des Enfants University Hospital

1211 Geneva 14

Switzerland

    >