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AOJPCH |
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INAUGURAL ISSUE : Volume One - JUNE 2002 -Number ONE |
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INTERVENTIONAL CARDIOLOGY IN INFANTS AND
CHILDREN (with special reference to developing countries) Dr Mazeni Alwi, MBBS (Queensland), MRCP (UK) Introduction The era of interventional cardiology in congenital heart disease was ushered in 20 years ago by the publication of Kan’s report on the first successful balloon dilatation of a stenotic pulmonary valve 1. This provided the impetus to investigate and broaden the application of balloon dilatation technique to other stenotic lesions such as aortic valvar stenosis, coarctation of the aorta and peripheral pulmonary stenosis2,3,4. Not long after, this was followed by techniques to close shunts such as patent ductus arteriosus (PDA) and atrial septal defect (ASD) 5,6. Today, catheter-directed therapy is a major aspect of treatment in congenital heart disease, with expanding indications and refinement of existing techniques to make them more efficacious and safe 7,8,9. This more or less parallels the development in paediatric cardiac surgery. As more complex lesions become amenable to treatment with at least reasonable mid-term outcome, increasingly catheter-based therapy converge with surgery as a combined multi-stage approach to management (9). Traditionally cardiac catheterization has been regarded as the gold standard of diagnosis in congenital heart disease. Anatomical abnormalities are delineated by angiocardiography and the haemodynamic derangements consequent to these aberrations can be determined by measurement of flow and pressure abnormalities, and quantification of shunts and vascular resistances. Correspondence: Dr Mazeni Alwi, Consultant Paediatric Cardiologist, National Heart Institute, 145, Jalan Tun Razak, 40500 Kuala Lumpur, Malaysia |
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Updated 15th August 2005 |
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© appassoc.org 2005
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