At present, the common congenital heart diseases suitable for catheter intervention in China mainly include
(1) Atrial septal defect (ASD, central type).
(2) Ventricular septal defect (VSD, perimembranous, muscular).
(3) patent ductus arteriosus (PDA, tubular, funnel)
(4) patent foramen ovale (PFO).
(5) pulmonary valve stenosis (PS)
(6) aortic stenosis (AS)
(7) arteriovenous fistula.
(8) aortic constriction (COA).
For ASD, VSD, PDA, arteriovenous fistula, etc., blocking is used (Amplatzer blocker is most commonly used), while for PS, AS, COA, etc., balloon dilation is used.
1.Pulmonary valve stenosis dilatation
It is mainly indicated for simple PS with transvalvular pressure difference ≥ 4.7 Kpa (35 mmHg); valve dysplasia type is mostly also effective; palliative therapy for complex congenital heart disease with PS; and dilatation therapy for postoperative restenosis. The balloon/valve annular ratio is generally between 1.1 and 1.5.
2.Percutaneous balloon aortic valvuloplasty
The balloon/valve annular ratio is less than 1. Balloon dilatation is still available for restenosis after stent placement after COA dilatation.
3. Indications for ASD occlusion
(1) Age usually ≥3 years.
(2) Central-type left-to-right shunt ASD of 4-35 mm diameter.
(3) distance from the edge of the defect to the coronary sinus, superior and inferior vena cava ≥5 mm, and to the atrioventricular valve ≥7 mm.
(4) The diameter of the interatrial septum is greater than the diameter of the left atrial side of the selected blocking parachute.
(5) Patients with ASD with residual shunts after surgery (left-to-right shunt).
(6) Patients with significant left-to-right shunts remaining after mitral valvuloplasty.
(7) Other cardiac malformations that are not comorbid and require surgical intervention
(8) With moderate or higher pulmonary hypertension, the tendency of pulmonary artery pressure and right ventricular descent should be confirmed by blocking test.
4. Indications for VSD occlusion.
(1) Age usually ≥ 3 years.
(2) Simple VSD with hemodynamic changes.
(3) Ventricular defect with the superior edge at least 2 mm from the aortic valve, without right coronary valve prolapse into the right ventricle and regurgitation; myocardial VSD: ≥5 mm in diameter; surgical residual shunt; ventricular defect after infarction or trauma.