[Acute therapy of cardiovascular malformations in infancy: non-surgical measures]

Non-surgical acute therapeutic procedures in infants replacing immediate surgery are mainly indicated in life threatening cyanosis and/or cardiac failure in the first 2 to 4 weeks of life. Balloon septostomy replacing surgical creation of an atrial septal defect, and pharmacological manipulation of the ductus with prostaglandin E in newborns (opening of ductus replacing aortopulmonary shunt) or by inhibition of prostaglandin synthesis with indomethacin in premature babies (ductus closure replacing ligation of ductus) are used routinely nowadays. Balloon dilatation of stenotic pulmonic or aortic valves (replacing valvotomy), balloon dilatation of coarctation of the aorta (replacing operative correction) and, rarely, closure of vessels with the help of catheters (replacing ligation) are being increasingly tried in this age group as well, though they do not yet belong to the routine methods.