Introduction

Interventional paediatric cardiology mainly involves dilatation of stenotic vessels or valves and occlusion of abnormal communications. Many transcatheter techniques—such as balloon dilatation, stent implantation, and coil occlusion—have been adapted from adult practice. Devices to occlude septal defects, developed primarily for children, have also found application in adults.

Basic techniques

Interventional procedures follow a common method. General anaesthesia or sedation is required, and most procedures start with percutaneous femoral access. Haemodynamic measurements and angiograms may further delineate the anatomy or lesion severity. A catheter is passed across the stenosis or abnormal communication. A guidewire is then passed through the catheter to provide a track over which therapeutic devices are delivered. Balloon catheters are threaded directly, whereas stents and occlusion devices are protected or constrained within long plastic sheaths.

Dilatations