Interventional cardiac catheterisation in congenital heart disease

Abstract

As a result of recent technological advances, more types of congenital heart disease are amenable to treatment in the cardiac catheter laboratory than ever before.1 Improved imaging techniques allow for better selection of patients, and the development of a wide range of devices specifically for use in children means that many patients can avoid surgery altogether, while those with complex congenital heart disease may require fewer or less complex surgical procedures.2 This allows for a quicker recovery and a shorter hospital stay, and gives many patients an improved quality of life in the short to medium term. However, the long term outcome for many of the newer forms of intervention is still unknown.

Figure 1

Angiographic pictures of stent insertion for re-coarctation following subclavian flap repair; (A) pre-procedure, (B) stent insertion, (C) stent expansion by inflation of internal balloon, (D) final result.

Figure 2

Angiographic pictures of radiofrequency perforation for pulmonary atresia; (A) catheter against imperforate valve (lateral projection), (B) radiofrequency wire across valve, (C) balloon dilation of valve perforation, (D) antegrade flow established.

Figure 3

Devices for duct occlusion: a pair of Amplatzer Ductocclude devices, and a pair of Cook MReye coils.

Figure 4

An Amplatzer Septal Occluder for closure of atrial septal defects.

Figure 5

A Helex device for closure of atrial septal defects.

Figure 6

Angiographic pictures of device occlusion of a VSD; (A) + (B) balloon sizing of the defect, (C) + (D) deployment of the device.

Figure 7

A pair of implantable pulmonary valved stents. The fine tissue of a closed valve is shown in the device on the left.