In recent years interventional procedures have been introduced to the
field of paediatric cardiac catheterization. These procedures continue
to develop in complexity and increasingly are being applied to patien
ts with reduced cardiovascular reserve, as an alternative to cardiac s
urgery or when cardiac surgery with cardiopulmonary bypass is contrain
dicated. More frequently anaesthetists are being called upon to provid
e support in sedating, anaesthetizing or/and resuscitating these patie
nts. The purpose of this review is to give a comprehensive update of t
he interventional procedures and to review the anaesthetic management
techniques as they apply to the catheterization laboratory. We will di
scuss s possible complications and management strategies from our own
experience and the experience of others. We have observed that as more
complicated procedures are performed the anaesthetist plays a pivotal
role in the management of the patient from arrival to departure from
the cardiac catheterization laboratory, and in preventing mortality an
d major morbidity. Although the economic consequences of interventiona
l cardiological techniques remain unclear, the field continues to expa
nd and more complex procedures are continually being introduced.