title: [Interventional therapy for complex congenital heart disease].
abstract: OBJECTIVE
  The advances in interventional cardiac catheterization have changed the therapeutic strategy for many patients with congenital heart diseases. The aim of this study was to evaluate the role of therapeutic cardiac catheterization in the treatment of complex congenital heart diseases.
  
  
  METHODS
  Balloon atrial septostomy (BAS) was performed in 59 children using Rashkind balloon catheter. Static balloon dilatation of the atrial septum was performed in 2 children with hypoplastic right heart syndrome. One child with pulmonary artery stenosis at the suture lines after arterial switch was treated with balloon dilatation. Percutaneous balloon pulmonary valvuloplasty (PBPV) and balloon angioplasty were performed in 15 children with tetralogy of Fallot (TOF). Transcatheter coil embolization was performed in 18 children with systemic to pulmonary collateral vessels and 5 children with B-T shunts before surgical procedures. Transcatheter closure of fenestration with Amplatzer septal occluder device was performed in 1 child who had undergone Fontan procedure.
  
  
  RESULTS
  In 46 children with transposition of great arteries (TGA), the arterial oxygen saturation (SaO(2)) was increased from 0.57 +/- 0.17 to 0.76 +/- 0.13 (t = 14.58, P < 0.01) after BAS. The pressure gradients across left and right atrium were less than 2 mmHg. The created atrial septal defects were 5 - 20 mm in size. In 10 children with pulmonary atresia with intact ventricular septum (PA/IVS), the arterial oxygen saturation did not change after BAS (t = 1.57, P > 0.05), but the pressure gradients across left and right atrium were less than 2 mmHg. In children with TOF, the arterial oxygen saturation was increased by 15 percent after PBPV and pulmonary valvular stenosis was relieved. In 14 of 18 children with systemic to pulmonary collateral vessels and 5 children with B-T shunts, complete occlusion was accomplished and the procedures were successful. In the child who had undergone Fontan procedure, the fenestration was occluded successfully and no complication was observed.
  
  
  CONCLUSIONS
  In management of complex congenital heart diseases, combination of surgical procedure and interventional catheterization therapy could be suggested to have better outcome.
authors.affiliation: Xinhua Hospital, Shanghai Children's Medical Center, Shanghai Second Medical University, Shanghai 200127, China.
authors.forename: Ai-qing
authors.initials: AQ
authors.lastname: Zhou
authors.forename: Rong-fa
authors.initials: RF
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.forename: Zhi-qing
authors.initials: ZQ
authors.lastname: Yu
authors.forename: Fen
authors.initials: F
authors.lastname: Li
authors.forename: Mei-rong
authors.initials: MR
authors.lastname: Huang
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods; D002404:Catheterization; D002648:Child; D006330:Heart Defects, Congenital / Q000628:therapy*; D006801:Humans; D019919:Prosthesis Implantation; D018633:Pulmonary Atresia / Q000628:therapy; D011666:Pulmonary Valve Stenosis / Q000628:therapy; D013771:Tetralogy of Fallot / Q000628:therapy; D014188:Transposition of Great Vessels / Q000628:therapy