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Congenital Heart Disease in the Adult: Interventional Therapy

  • Chapter
Cardiovascular Medicine

Abstract

  • Balloon valvuloplasty and balloon angioplasty now are applied effectively to all four cardiac valves and all major blood vessels in children with cardiovascular diseases.

  • Aortic valvuloplasty is done in children with valvular aortic stenosis with a systolic gradient greater than or equal to 50 mm Hg at rest, or a peak gradient of 40 to 50 mm Hg with symptoms or signs of ischemia.

  • The most typical form of congenital mitral stenosis consists of thickened leaflets and shortened chordae tendineae with decreased interchordal spaces. Other forms include supravalve mitral membrane and a parachute mitral valve.

  • The techniques for relieving congenital or surgically acquired vascular lesions by balloon angioplasty and stents now are routine and employed with variable success for stenoses anywhere within the great vessels.

  • The discrete, shelf-like coarctation of the aorta represents the ideal lesion for successful dilation.

  • Obstruction to systemic veins in patients with congenital heart disease usually is iatrogenic.

  • Congenital pulmonary vein stenosis is very rare and usually occurs with other congenital heart lesions with or without associated surgical intervention.

  • The final suitability of an atrial septal defect for transcatheter closure is determined by transesophageal echocardiography (TEE) and confirmed during cardiac catheterization with an accurate balloon sizing of the defect.

  • The major indications for closing a patent foramen ovale (PFO) are significant right to left shunting through it, and a documented central nervous system (CNS) embolic event in the presence of a PFO.

  • Interventional cardiologists have been occluding the patent ductus arteriosus (PDA) nonsurgically for almost four decades.

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Authors and Affiliations

  1. Department of Pediatrics, Baylor College of Medicine/Texas Children’s Hospital, Houston, TX, USA

    Charles E. Mullins MD

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  1. Charles E. Mullins MD
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Editors and Affiliations

  1. The University of Texas Health Science Center in Houston, Houston

    James T. Willerson MD (President, President-Elect and Medical Director) (President, President-Elect and Medical Director)

  2. Texas Heart Institute, Houston, TX, USA

    James T. Willerson MD (President, President-Elect and Medical Director) (President, President-Elect and Medical Director)

  3. Department of Cardiology, University of Maastricht, Masstricht, The Netherlands

    Hein J. J. Wellens MD (Emeritus Professor) (Emeritus Professor)

  4. Rasmussen Center for Cardiovascular Disease Prevention Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA

    Jay N. Cohn MD (Professor of Medicine and Director) (Professor of Medicine and Director)

  5. Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA

    David R. Holmes Jr. MD (Consultant, Professor of Medicine and Scripps Professor) (Consultant, Professor of Medicine and Scripps Professor)

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© 2007 Springer-Verlag London Limited

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Mullins, C.E. (2007). Congenital Heart Disease in the Adult: Interventional Therapy. In: Willerson, J.T., Wellens, H.J.J., Cohn, J.N., Holmes, D.R. (eds) Cardiovascular Medicine. Springer, London. https://doi.org/10.1007/978-1-84628-715-2_12

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  • DOI: https://doi.org/10.1007/978-1-84628-715-2_12

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