The common congenital heart diseases currently suitable for catheter intervention in China are.
(1) Atrial septal defect (ASD, central type).
(2) ventricular septal defect (VSD, perimembranous, myocardial)
(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 or 7 Kpa (35 mmHg); valve dysplasia type is mostly also effective; palliative therapy for complex congenital heart disease with PS; and dilation 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 annulus ratio is less than 1. Balloon dilatation is still available for postoperative restenosis after stent placement after COA dilatation.
3. Indications for occlusion of ASD.
(1) Age usually ≥3 years.
(2) Central-type left-to-right shunt ASD of 4-35 mm in 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) diameter of the atrial septum greater than the diameter of the left atrial side of the selected blocking parachute.
(5) Patients with ASD with residual shunts after surgical procedures (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 necessitate 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 occlusion of VSD: Membrane.
(1) Age usually ≥ 3 years.
(2) Simple VSD with hemodynamic alterations.
(3) VSD with the superior edge of the ventricular defect 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.