Interventional approach to congenital heart disease

Abstract

Purpose of review: This review summarizes important publications and advances in the field of interventional pediatric cardiology. The article focuses on new interventional techniques, devices, and catheter equipment and reviews modifications and advances made in already well-established techniques such as atrial septal defect device closure. Some interventions that reflect mainly the adult population, such as patent foramen ovale device closure and closure of postinfarct ventricular septal defects, are also discussed.

Recent findings: The recent results of device closure of perimembranous ventricular septal defects using the Amplatzer membranous ventricular septal defect device have been encouraging. We discuss a modification of the delivery system for the membranous ventricular septal defect device that is aimed to overcome the difficulty in correctly positioning the device and delivery sheath. Important device modifications discussed in this article include the angled Amplatzer Ductal Occluder, the cribriform atrial septal defect device for use in multifenestrated atrial septal defects and the fenestrated atrial septal defect device. The hybrid approach to congenital heart disease is discussed in this article.

Summary: Interventional pediatric cardiology is a constantly evolving specialty. Surgical procedures are being partially replaced by percutaneous interventions or hybrid approaches. We believe that the primary treatment for coarctation beyond the neonatal period as well as for muscular ventricular septal defects should be the transcatheter approach.