Interventional catheterization in surgically treated patients with congenital heart disease

Interventional catheterization is an alternative to surgery for some congen ital heart defects. For other malformations, the surgeon and the interventi onist will join in an effort to obtain an optimal result: the typical examp le is pulmonary atresia with VSD and aortopulmonary collaterals. In other c ases, the cardiologist may be called upon to intervene with catheter techni ques to correct sequelae or residual lesions after surgical correction, avo iding redo surgery. Most often, the task consists of opening stenoses by ba lloon dilatation and/or stenting the main targets being pulmonary artery br anch stenoses, venous obstructions after Mustard procedure, and recoarctati ons. Whereas simple balloon dilatation of recoarctation often brings good r esults, stents are often needed to obtain optimal results in pulmonary bran ch stenoses. Stenting of pulmonary veins has been disappointing. Closing un wanted vessels and defects is another task for the interventional cardiolog ist after cardiac surgery. Here, the most frequent procedure is closing aor topulmonary collaterals in pulmonary atresia and VSD after corrective surge ry. Advantages and limitations of these procedures are discussed.