15:00 〜 15:30
[II-IL-06] Current advances in Pediatric Interventional Cardiology; from Bench to Cath lab
There has been a revolution in cardiac catheterization over the last two decades. Improvements from fetal life to adulthood were achieved by technical innovations and physiopathological-based novel strategies. Minimal-invasive procedures could be achieved despite concomitant surgical improvements.
Considering the heart and circulation as an unity, transcatheter interventions were developed to treat vessel obstructions from systemic and pulmonary veins to heart-neighboring great arteries, even lymphatic interventions became successfully to treat Fontan-patients with plastic bronchitis. Fetus and newborns with obvious univentricular hearts could be palliated by pre-and postnatal interventions, in part to resuscitate a bi-ventricular circulation. Transcatheter devices are meanwhile routinely used to close intracardiac defects, but it became obvious that not any hole should be closed; in opposite, creation of atrial communication might be a novel strategy in particular to treat diastolic failing hearts, meanwhile diastolic devices are developed from several companies. We learned by observing the nature that communications achieving a parallel circulation might be able to avoid or delay heart, heart-lung transplantation. Obstructed valves can be efficiently ballooned, the aortic valve by utilizing rapid pacing; replacement of the pulmonary and in adults of the aortic valve became to a routine approach, the tricuspid and mitral replacement by individualized procedures. Absorbable stents and devices are still in development, but currently not available as it would be appreciated by all pediatric cardiologists worldwide.
Considering the heart and circulation as an unity, transcatheter interventions were developed to treat vessel obstructions from systemic and pulmonary veins to heart-neighboring great arteries, even lymphatic interventions became successfully to treat Fontan-patients with plastic bronchitis. Fetus and newborns with obvious univentricular hearts could be palliated by pre-and postnatal interventions, in part to resuscitate a bi-ventricular circulation. Transcatheter devices are meanwhile routinely used to close intracardiac defects, but it became obvious that not any hole should be closed; in opposite, creation of atrial communication might be a novel strategy in particular to treat diastolic failing hearts, meanwhile diastolic devices are developed from several companies. We learned by observing the nature that communications achieving a parallel circulation might be able to avoid or delay heart, heart-lung transplantation. Obstructed valves can be efficiently ballooned, the aortic valve by utilizing rapid pacing; replacement of the pulmonary and in adults of the aortic valve became to a routine approach, the tricuspid and mitral replacement by individualized procedures. Absorbable stents and devices are still in development, but currently not available as it would be appreciated by all pediatric cardiologists worldwide.