Abstract: Since Dotter et al. pioneered cardiovascular interventional therapy in 1964, with the development of experimental, clinical, and interventional material research, interventional therapy for congenital heart disease has been continuously developed and perfected, especially in the past five years has been developed rapidly, and can achieve curative effect on some common congenital heart diseases. This treatment method has the advantages of easy operation, less pain, high success rate, safe and effective, no complications, etc. Qinghai is located in the Tibetan plateau, and the incidence of congenital heart disease is significantly higher than that in the plains, accounting for about 7%-14% (average 13.6%), and the development of interventional treatment has brought gospel to the majority of patients with congenital heart disease. Key words: congenital heart disease, interventional therapy, cardiac surgery department of Qinghai Cardiovascular Hospital, Wang Liming, congenital heart disease is the most common heart disease in pediatric period, and it is estimated that about 150,000 newborn children with congenital heart disease are born in China every year, which is a common cardiovascular disease in pediatric period, therefore, timely diagnosis and treatment of these children is the key to reduce the complications and mortality of congenital heart disease. In recent years, with the research and development of experimental, clinical and interventional materials, the types and numbers of interventional treatments for congenital heart disease have increased rapidly, and they have been able to treat all types and diameters of arteriovenous ductus arteriosus, most of the secondary foramen ovale defects, membranous, muscular and intracrural ventricular septal defects, coronary arteriovenous fistula, aortic stenosis, pulmonary stenosis, mitral stenosis, Ludenbar’s syndrome, Farrer’s triad and so on. This has led to a fundamental change in the traditional treatment of congenital heart disease. The following is a brief review of the current status and future outlook of interventional treatment of congenital heart disease in our province.1. The research on occlusion of unclosed arterial ducts has been conducted for 37 years, and Porstman et al. first reported the successful occlusion of unclosed arterial ducts with foam sponge plugs delivered via cardiac catheter in 1967. The Rashkind double-sided umbrella, the Sideris button-type patch, and the spring-loaded coil were used to occlude unclosed ducts. In 1997, Amplatzer first introduced the mushroom umbrella plug (4), which, compared with previous plugging materials, has enabled the interventional treatment of congenital heart disease to develop rapidly worldwide due to its unique design, excellent performance and simplified surgical approach. The goal of not requiring surgical open-heart surgery for the treatment of patent ductus arteriosus has been reached with rapid development. Since 1991, our hospital has been exploring the occlusion of unclosed arterial ducts, and has used foam sponge plugs, spring coils and Amplatzer to occlude nearly 1600 cases of unclosed arterial ducts, with the youngest being 14 months old, the oldest being 64 years old, and the youngest being an 8 kg child, with the smallest being 2 m in diameter and the thickest being 28 mm. The success rate of blocking was 99%, and the blocking device was dislodged in 3 cases with a hospital stay of 5 days, which achieved good clinical results. Therefore, occlusion of unclosed ductus arteriosus has become the safe and effective method of choice for the treatment of unclosed ductus arteriosus today. Arteriovenous catheter closure with severe pulmonary hypertension has been a difficult problem in cardiac surgery in the past, and has been excluded from surgical indications due to high surgical risks, complications and high mortality, and most patients cannot receive timely and effective treatment and lose the best treatment time. The interventional treatment carried out today is less traumatic, less painful, less risky, and can continuously and dynamically detect aortic pressure, pulmonary artery pressure and arterial oxygen saturation, which can immediately determine the efficacy of occlusion and can be retrieved at any time if necessary, so that these patients have been effectively treated and are welcomed by patients and clinicians, but there are still some problems that deserve to be discussed and improved, especially the recent postoperative condition of individual patients has However, there are still some problems that deserve to be explored and improved, especially the tendency of further deterioration of individual patients’ recent postoperative conditions, which must be highly emphasized by interventionalists. From 2003 to 2011, a total of 134 cases of arterial catheter failure and severe pulmonary hypertension were treated in our hospital, 78 cases in men and 56 cases in women, with an average age of 17.6 years. All of them had post-activity panic, shortness of breath, weakness and swelling of both lower limbs, and mild systolic murmurs could be heard between the 2nd and 3rd ribs at the left edge of the sternum, radiographs: increased blood in both lungs, prominent pulmonary artery segments, enlarged left and right ventricles, and the ratio of chest to heart was >0.60. All patients were routinely given preoperative intermittent oxygen, cardiac stimulation, diuretics, and hypotension. After blocking the arterial catheter, the aortic pressure and pulmonary artery pressure were continuously and dynamically measured, and the patient’s condition was observed for 30 minutes to 1 hour, if the systolic pressure of the pulmonary artery decreased by more than 30 mmHg and the arterial oxygen saturation was >91%. If the systolic pressure of the pulmonary artery drops by more than 30 mmHg, the arterial oxygen saturation is >91% and the patient has no systemic reaction, the blocker can be released. After the operation, the patients were still given antihypertensive, cardiotonic and diuretic treatment for 3-6 months, and the follow-up period ranged from 6 months to 8 years. 132 cases showed significant improvement, and the patients’ activity increased. It is difficult to determine whether pulmonary vascular lesions are reversible in patients with unclosed ductus arteriosus with pulmonary hypertension, because the extent of pulmonary artery lesions cannot be completely clarified from symptoms and cardiac catheterization data alone, and it is difficult to biopsy pulmonary vessels, so we mainly judge from the following aspects: (1) a decrease in pulmonary artery systolic pressure of 15 mmHg or more in the prostaglandin E drug test indicates that pulmonary hypertension is dynamic, and it is safer to block it, and vice versa (1); ② QP/QS ≥ 1.3, arterial oxygen saturation > 91%, blocking test pulmonary artery systolic pressure drop of 30 mmHg or more, is the ideal indication for blocking, pulmonary artery systolic pressure drop is unsatisfactory or no change, suggesting that the pulmonary artery lesion is resistance changes, poor prognosis, should give up blocking (1, 2); ③ exercise load test, after 20 minutes of exercise, if the arterial oxygen If the arterial oxygen saturation is >91% or more after 20 minutes of exercise, it can be used as one of the indications for occlusion, and if the arterial oxygen saturation is <90% after exercise, the occlusion should be abandoned. ④ Nuclear pulmonary perfusion imaging, whose parameters correlate with the degree of small pulmonary artery lesions (3), has clinical application in the evaluation before occlusion, selection of occlusion indications and postoperative follow-up of congenital heart disease combined with pulmonary hypertension, especially for pediatric cases. Despite the success of occlusion in some patients with very severe pulmonary hypertension, there is no better way to determine whether small pulmonary artery lesions are reversible, so occlusion in similar cases is risky and the prognosis is unpredictable, and patients should be informed of the treatment risks (1, 2). Thankfully! More and more clinicians are beginning to pay attention to the research and discussion of interventional treatment of pulmonary hypertension, and with the improvement of methods and devices and the accumulation of experience, it is believed that the interventional treatment of congenital heart disease combined with pulmonary hypertension will be more perfect, safe and effective, so that more patients will benefit.2. Atrial septal defect occlusion Atrial septal defect is one of the common congenital heart diseases. Secondary foramen ovale defect is its most common type, accounting for about 84%. Previously, surgery was the only treatment method, but with the improvement of instruments and delivery systems, the interventional treatment of secondary foramen ovale septal defect has gradually matured (8, 10). 1997, Amplatzer invented a double-disc nickel-titanium alloy blocker, which has the following advantages: ① easy operation; ② double-disc structure has the function of restoring memory shape; ③ wide indications; ④ high safety; ⑤ high success rate; ⑥ short hospital stay. Therefore, in just a few years, Amplatzer blocker has been popularized rapidly worldwide, and more than 840 cases of congenital atrial septal defect have been blocked by Amplatzer blocker in our hospital. The success rate of surgery was 99%, with 3 cases of dislodged blockers and 2 cases of acute pericardial tamponade, which were improved by perforation and drainage. This new method has been accepted by the majority of patients and their families, and has brought a boon to patients with atrial septal defect. In recent years, the relationship between the presence of patent foramen ovale and the occurrence of cerebral thrombosis has received increasing attention abroad. The incidence of patent foramen ovale accounts for 25%-34% of the population, and patent foramen ovale is associated with unexplained cerebral embolism and migraine (7), of which 10%-40% can occur due to paradoxical thrombosis, and the incidence of cerebral embolism is still in the range of 10%-29% even with anticoagulation therapy for these patients. An international multicenter study organized by Switzerland has demonstrated that the application of Amplatzer blocker to occlude the foramen ovale is significantly better than drug therapy in preventing cerebral embolism associated with foramen ovale occlusion (6, 7). Therefore, domestic and foreign scholars pay much attention to the active treatment of foramen ovale non-occlusion, and 98 cases of foramen ovale non-occlusion were completed in our hospital. The syncope and migraine disappeared in all patients.3. Interventional treatment of ventricular septal defect in the previous years is a controversial issue that has yet to be further resolved. In recent years, the Amplatzer occluder has been reported to be used clinically to occlude myocardial ventricular septal defects due to its aforementioned advantages (8). In recent years, the new Amplatzer ventricular septal defect blocker and delivery system have been used in clinical practice, which has led to a new breakthrough in the interventional treatment of ventricular septal defects, which is easy and safe to operate, and can be used to block not only myocardial ventricular septal defects but also membranous ventricular septal defects (8, 90). "With the maturation of technology and the development of new devices, the interventional treatment of ventricular septal defect will be further promoted and applied. A total of 141 cases of ventricular septal defect blocking were completed in our hospital, including 126 cases of perimembranous ventricular septal defect, 8 cases of intracristal defect and 7 cases of myocardial defect. There were no blocker displacement, conduction block, or residual shunt.4 Valvuloplasty includes percutaneous balloon pulmonary stenosis dilatation and mitral valve stenosis balloon dilatation and plasty. Among them, pulmonary stenosis dilationplasty has the best effect (1, 4, 5). For typical pulmonary stenosis, the long-term postoperative follow-up is good and has replaced surgical open-heart surgery, with satisfactory long-term results. 158 cases of dilationplasty have been completed in our hospital, and after surgery, the pulmonary transvalvular pressure difference decreased, cyanosis disappeared, arterial oxygen saturation increased, and the patient's activity increased significantly. No restenosis was observed at follow-up. Thus, balloon dilatation and angioplasty has become the preferred and effective treatment for pulmonary stenosis in cases of congenital pulmonary stenosis simplex (2) (5). Balloon dilatation angioplasty was performed for simple type mitral stenosis, and 45 cases were completed in our hospital with satisfactory recent results, with significant reduction in patient symptoms and improvement in cardiac function, but patients should enhance self-care after balloon dilatation angioplasty to prolong restenosis (3, 4, 3). More experience has been accumulated in balloon dilation and angioplasty for valvular stenosis, which is now more targeted in terms of indications and methodological choices. The recent results of balloon dilation and the incidence of postoperative restenosis are not consistent for pulmonary branch stenosis and other vascular stenoses, and the placement of stents after balloon dilation and angioplasty is expected to reduce catastrophic stenosis, which needs to be further studied and improved.5. Interventional treatment of complex congenital heart diseaseComplex type Interventional treatment of congenital heart disease is also a hot topic of attention in recent years, and it is a major trend to treat certain congenital heart diseases in collaboration with surgery. For severe tetralogy of Fallot, severe stenosis or atresia of the pulmonary valve, and double outlet of the right ventricle, balloon valve dilation can be used for treatment, and balloon dilation and stent placement can be used for pulmonary valve stenosis, and the intervention can be repeated as the pediatric growth and development reaches a certain age to adapt the hemodynamics to physical development. A complex group of malformations with pulmonary atresia + ventricular septal defect is first treated by applying interventional therapy to embolize the body-pulmonary collateral circulation, and then surgically performing radical surgery to avoid surgical field restrictions that prevent adequate ligation of these collateral branches and improve the success rate of surgery (1, 2, 6). In addition, arteriovenous ductus arteriosus, ventricular septal defect, residual leak after surgery for atrial septal defect, perivalvular leak after valve replacement, and septal perforation after acute myocardial infarction can be occluded by interventional therapy, and satisfactory results have been achieved. For most of the common congenital heart disease can achieve the effect of cure, some complex congenital heart disease using intervention and surgery combined, expanding the indications and success rate of surgery, therefore, it is necessary to promote this new treatment technology.6.Future and Prospects Interventional therapy of congenital heart disease is a new discipline integrating cardiac surgery, cardiology, radiology, ultrasound imaging and cardiac catheterization technology. Due to the limitation of conditions, it can only be carried out in some hospitals with good conditions in China, and the imported blocking equipment is expensive and the medical cost is high, which limits the wide application in clinical practice. Happily, many hospitals in Beijing, Shanghai, Guangzhou, Shenyang, Chengdu, Xi'an, Qinghai and other places in China have carried out the new technology of interventional treatment of congenital heart disease, and progress has been made in the development of localization of devices. It is a major trend in this field that more and more patients receive interventional treatment. References 1. Ruping Dai. Preliminary analysis of the current situation of interventional treatment for congenital heart disease in China [J]. Hainan Medicine, 2002, 13(12): 112-115. 2. Zhang Yushun, Zhu Xiangyang, Zhang Jun et al. Advances in interventional and ultrasound diagnosis of congenital heart disease. Xi'an: World Book Publishing Company, 2005.166:10-98. 3. 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