Interventional Catheterization in Adult Congenital Heart Disease

Treat and Repair Strategy in Patients With Atrial Septal Defect and Significant Pulmonary Arterial Hypertension

“…References for the hemodynamic criteria for recommendation of closure of the interatrial shunt were Qp/Qs ≥1.5 and PVR <8 Wood units. 13 Transcatheter closure of the ASD was performed under general anesthesia with fluoroscopic and transesophageal echocardiographic guidance. The procedure was performed using an Amplatzer septal occluder (St. Jude Medical, St. Paul, MN, USA).…”

2012 American College of Cardiology Foundation/Society for Cardiovascular Angiography and Interventions Expert Consensus Document on Cardiac Catheterization Laboratory Standards Update

“…Most of the individual procedures are performed in relatively small numbers. These procedures include atrial septostomy, valvuloplasty, angioplasty, stent implantation in large vessels, vascular closure (patent ductus arteriosus, other anomalous vessels, and fistulae), device closure of atrial communications and ventricular septal defects, transcatheter valve implantation, endomyocardial biopsy, foreign-body retrieval, pericardiocentesis, and a range of electrophysiological procedures (298,299). Expertise in these procedures is acquired during pediatric cardiology fellowship training and in pediatric cardiology post-fellowship training in the interventional cardiac catheterization laboratory (often during an additional training year) (300).…”

Pathophysiology of Congenital Heart Disease in the Adult, Part II

“…The occurrence of symptoms and serious dysrhythmic events is generally related to the peak-to-peak gradient across the valve. 9 Interestingly, we, and others, 10 have observed that moderate valvar gradients, which may be very well tolerated in children, appear to become more important clinically with aging in adults. This may be due to the normal ventricular myocardial stiffening frequently associated with aging.…”