[Interventional catheterization in the treatment of congenital and acquired heart defects]

The treatment of heart defects by interventional catheterization started in 1982, when the first report on balloon dilatation of pulmonary valve stenosis was published. Similar techniques have since been extended to many other lesions. Presently, two types of catheter intervention have come into use. The first is dilatation of stenotic lesions by inflatable balloons: the main defects treated include pulmonary valve stenoses, aortic valve stenoses, coarctation of the aorta and peripheral pulmonary artery stenoses. Second, it is now possible to close defects and unwanted vessels, such as a persistent ductus arteriosus, with umbrella-like devices introduced through catheters. While balloon dilatation has clearly become the treatment of choice for pulmonary valve stenosis, other applications remain either controversial (e.g. balloon dilatation of coarctation) or experimental (e.g. closure of atrial or ventricular septal defects). Time will tell what is the exact role of interventional cardiology, keeping in mind that surgery provides excellent results with minimal morbidity and mortality in these lesions.