Text Box: INTERVENTIONAL CATHETERIZATION FOR COMBINED CONGENITAL HEART DISEASE: SEVEN CASES REPORT
LI F, ZHOU A-Q, GAO W, YU Z-Q
Shanghai Children’s Medical Center, Shanghai, China

Objective: To investigate the tactics of intervention catheterization for combined congenital heart disease and evaluate its efficacy.
Methods: From July 1997 to October 2000, 7 patients (6 male, 1female) underwent transcatheter intervention for combined congenital heart disease. Their mean age was 5±4.65 years. Types of combination were: pulmonary stenosis (PS) and patent ductus arteriosus (PDA), 3 cases; atrial septal defect (ASD) and PDA, 2 cases; coarctation of the aorta (CoA) and aortic stenosis (AS),1 case; CoA and PDA, 1 case. Tactics of transcatheter intervention was: for PS and PDA, percutaneous balloon pulmonary valvuloplasty first, occlusion of PDA later; for ASD and PDA, occlusion of PDA first, ASD later; for CoA and AS, percutaneous balloon aortic valvuloplasty first, dilation of CoA later; for CoA and PDA, dilation of CoA first, occlusion of PDA 2 months later. The patients were followed up periodically.
Results: Transcatheter intervention for combined congenital heart disease was successful in all patients. Immediately after the procedure, there was no residual shunt in occluded PDAs or ASDs. Gradients across pulmonary valve, aortic valve and coarctation site decreased from 95±34.60 mmHg to 17±5.20 mmHg, 72mmHg to 20mmHg, and 32 mmHg and 45 mmHg to 6 mmHg and 13 mmHg ,respectively, post-procedure. At 1.42±1.23 year follow-up, no residual shunt occurred and gradients across valve or coarctation site were within the limits of satisfactory results. No complications were observed.
Conclusion: Transcatheter intervention for combined congenital heart disease is more difficult and demands higher-level technology. However, if indications and tactics of procedures are appropriate and manipulations conform to standard, good results can be obtained as well.
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