Transcatheter Interventions for Neonates with Congenital Heart Disease: A Review

Abstract

Newborns with congenital heart disease often require interventions linked to high morbidity and mortality rates. In the last few decades, many transcatheter interventions have become the first-line treatments for some critical conditions in the neonatal period. A catheter-based approach provides several advantages in terms of procedural time, length of hospitalization, repeatability and neurodevelopmental issues (usually related to cardiopulmonary bypass). The main transcatheter procedures will be reviewed, as they are now valid alternatives to conventional surgical management.

Balloon Valvuloplasty in Congenital Critical Aortic Valve Stenosis in Neonates and Infants: A Rescue Procedure for the Left Ventricle

“…For this purpose, it is useful to fixate the guiding wire in the descending aorta using a retrieval loop, as first described by Rao et al [18] in a trans-umbilical approach. Other options for intra-procedural balloon stabilization are rapid pacing or inducing short-term asystole by adenosine administration [43]. In three of our patients, antegrade access had to be chosen in the first intervention, but retrograde access was feasible in the second (n = 1) or third (n = 2) procedure.…”

Instant Detection of Cerebral Blood Flow Changes in Infants with Congenital Heart Disease during Transcatheter Interventions

“…An increasing number of CHDs are now being treated by minimally invasive interventions with transcatheter balloon valvuloplasty/angioplasty, device closures, and stents as definitive treatment or part of hybrid approaches [ 1 , 6 , 7 ]. However, it is important to note that transcatheter interventions may affect cardiac output and cerebral circulation.…”