CURRENT RESULTS OF CARDIAC CATHETER INTERVENTIONS IN CONGENITAL HEART-DISEASE

Cardiac catheter interventions have gained importance in pediatric cardiology and have completely replaced surgery for certain indications. Balloon dilation of the pulmonary valve is the first line of therapy and achieves permanent relief of stenosis. Dilation of valvular aortic stenosis is also considered therapy of choice; mostly mild aortic insufficiency is induced in 15-20%, restenosis is rare. Beyond the newborn period, balloon dilation of aortic coarctation is successful for postsurgical and native stenoses. The longterm risk of aneurysm formation for dilated native lesions is still unclear. About 50% of pulmonary artery stenoses are amenable to dilation; With stent implantation, even 80% are treated successfully. Placement of stents in other areas is under investigation. Membranous pulmonary atresia can be opened by radiofrequency or laser and subsequent balloon dilation. Transvenous closure of the patent ductus arteriosus has become routine for patients above 6 kg bodyweight. In about 85% closure is complete and permanent. Certain atrial septal defects and muscular ventricular septal defects can also be closed transvenously. Various suitable implants are being investigated. Apart from closure of pathological vessels and ablation of accessory electrical pathways, numerous other interventions are available for special problems.