Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease

Predictors of Inadequate Mixing in Transposition of the Great Arteries — a Critical Neonatal Condition

“…11,12 Balloon atrial septostomy (BAS) with echocardiographic guidance, performed at the bedside, is the method of choice to enlarge the interatrial communication in neonates with TGA. 13,14 Severe cyanosis is the clinical sign of poor mixing.…”

Late Coarctation Presenters Suffer Chronic Hypertension Resisting to Medicine Treatment

“…For infants or young children presenting with native CoA, most centers prefer surgical repair due to the long-term risk of aneurysm following BA, the need for re-dilatation with stent placement in near future, and the limitations imposed by small arteries unable to accommodate larger sheath sizes [23]. However, BA can be considered as a palliative strategy in stabilizing critical ill neonates considered too sick for immediate surgical repair [24]. Surgical repair may also be more appropriate in patients with complex CoA anatomy, including those with transverse arch obstruction, tortuous segments of re-CoA, distortion of adjacent arterial branches, or when repair of associated cardiac defects is required [22].…”

“…In the older child ( with a body weight over 25 Kg), adolescent, or adult presenting with a simple, juxtaductal, native CoA, stent placement is considered a reasonable approach, offering a less invasive alternative to surgical intervention and good longterm outcomes [21]. Only stents expandable to an adult size should be used, to avoid later surgical intervention [24]. For Citation: Petropoulos recurrent CoA in the younger child, it is reasonable to consider initial BA, as aneurysm is less of a long-term concern than with native CoA [24].…”

Tailored management approach for late presenters and critically sick children with congenital heart disease

“…In the industrialized countries, where most of these standards of care were developed and implemented, the advanced and well-structured health care delivery helped to evaluate these management strategies [4,5]. In contrast, in many developing countries, the health care level does not always support to implement these recommendations [6].…”