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[Interventional catheter therapy in childhood]
1Kardiologische Abteilung, Universitäts-Kinderklinik Zürich.
Insights
Paediatric therapeutic heart catheterization offers minimally invasive options for congenital heart disease, serving as an alternative or supplement to surgery. Interventional therapies like balloon valvuloplasty and device occlusion are increasingly vital for effective treatment.
Area of Science:
- Cardiology
- Paediatric Cardiology
- Interventional Cardiology
Background:
- Congenital heart disease treatment is evolving.
- Minimally invasive approaches are gaining importance.
Purpose of the Study:
- To highlight the growing role of paediatric therapeutic heart catheterization.
- To outline various interventional techniques and their current applications.
Main Methods:
- Balloon valvuloplasty for stenotic valves/vessels.
- Stent implantation.
- Occlusion of defects (e.g., atrial/ventricular septal defects) using coils or umbrella devices.
- Occlusion of unwanted vascular structures.
Main Results:
- Balloon valvuloplasty for pulmonary valve stenosis and embolisation of small vessels are established treatments.
- Interventions for aortic stenosis, coarctation, peripheral pulmonic stenosis, and patent ductus arteriosus are valuable surgical alternatives.
- Atrial/ventricular septal defect occlusions and stent implantations are investigational but promising.
Conclusions:
- Paediatric therapeutic heart catheterization is a crucial and expanding field in congenital heart disease management.
- Interventional cardiology provides effective alternatives to surgery for various conditions.
- Further research into long-term outcomes of newer interventions is warranted.
Abstract:
The paediatric therapeutic heart catheterization becomes more and more important in the treatment of congenital heart disease. Depending on the situation, interventional therapy can become an alternative or a replacement or supplement to surgical intervention. The methods of interventional therapy include the balloon valvuloplasty of stenotic valves or vessels, the implantation of stents and the occlusion of defects as well as of unwanted vascular structures with coil embolisation or umbrella devices. The balloon valvuloplasty of pulmonary valve stenosis or the embolisation of small vessels have become the treatment of choice. Valvuloplasty of aortic stenosis, angioplasty of residual coarctation, balloon dilatation of peripheral pulmonic stenosis and occlusion of a patent ductus arteriosus with a Rashkind PDA-occluder are now a valuable alternative to surgical procedure although studies of long-term results are not yet available. Occlusions of atrial or ventricular septal defects as well as the implantation of stents are still investigational tools, but give enormous hope for the future.