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.
Key words:
Catherisation - Congenital heart disease -
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Béat Friedli, MD
Hôpital des Enfants University Hospital
1211 Geneva 14
Switzerland
