Early experience with pediatric cardiac intervention in Songklanagarind Hospital.
BACKGROUND
Nowadays, pediatric cardiac intervention is an effective optional treatment for congenital heart disease (CHD). Several cardiac centers have been established in different regions of Thailand and Songklanagarind Hospital is the newest of these university cardiac centers.


OBJECTIVE
To report results and complications of transcatheter treatment for congenital cardiac defects in Songklanagarind Hospital.


METHODS
The medical database was reviewed for the results and complications of different types of pediatric cardiac intervention from May, 2000 to December, 2003.


RESULTS
There were 102 cases of pediatric cardiac intervention. Sixty-seven were patent ductus arteriosus (PDA), 16 were valvular pulmonary stenosis (VPS), 10 were cyanotic CHD which needed balloon atrial septostomy (BAS), 8 were abnormal aorto-pulmonary (AP) collaterals, and 1 was severe valvular aortic stenosis (VAS). Coil embolization was performed in 53 patients with PDA and 8 patients with AP-collateral vessels, 32 of PDAs (60.4%) and all AP-collateral vessels (100%) were completely obliterated within 24 hours. The Amplatzer duct occluder (ADO) was deployed in 14 PDAs with 100% completely obliteration within 24 hours. In those with VPS or VAS, percutaneous balloon valvuloplasty (PBV) was the treatment of choice. The mean peak to peak systolic pressure gradient in VPS was reduced from 62.8 +/- 33.3 mmHg to 33.33 +/- 33.33 mmHg and from 76 mmHg to 49 mmHg in VAS after the procedures. In BAS, the mean diameter of atrial communication increased from 3.0 +/- 0.7 mm to 5.9 +/- 0.4 mm. In coil embolization, 8 had distal PA embolization (15%), 1 had hemolysis (2%) and 1 had decreased dorsalis pedis pulse (2%). One (7%) of the ADO-implanted patients had a weak femoral pulse. Of the VPS cases, 1 died from intractable heart failure, and 1 developed hemiparesis, from which they completely recovered within 6 months. The patient with VAS had a femoral artery complication.


CONCLUSIONS
Pediatric cardiac intervention in Songklanagarind Hospital has satisfactory results with an acceptable complication rate.
Promphan
Worakan
W
Department of Pediatrics, Prince of Songkhla University, Hat Yai, Songkla 90110, Thailand. pworakan@yahoo.com
Sopontammarak
Somkiat
S
Jantarapratin
Somrit
S
D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D013785:Thailand / Q000453:epidemiology