Cardiac catheterization has long been a central diagnostic modality
in the evaluation of children, adolescents, and adults with
congenital heart disease, and in children with acquired heart
disease. Over the past two decades, transcatheter interventions
have become equally important in the treatment of pediatric and
congenital heart disease. Some transcatheter therapies have become
established as the standard of care for congenital cardiovascular
anomalies previously managed surgically, others serve to supplement
surgery in the integrated management of complex lesions, and still
others are in their infancy, as pediatric interventional cardiology
continues to advance in step with the broader field of pediatric
cardiovascular medicine. Since the previous edition of this book,
new technologies and techniques have been introduced to the field
of pediatric interventional cardiology, much has been learned about
established transcatheter therapies, and there has been a
substantial increase in the volume of published data on outcomes of
transcatheter procedures in congenital and pediatric heart disease.
With increasing experience, the role of interventional
catheterization has become solidified as an integral component of
the comprehensive management of patients with essentially all forms
of congenital heart disease. Cardiac catheterization has also
become established as a distinct subspecialty within the discipline
of pediatric cardiology, and at many centers has become the purview
of cardiologists who have received specialized training in
interventional catheterization and whose practice is focused on
catheterization. This book is targeted to trainees and established
interventional cardiologists alike, and is intended as a
comprehensive reference for the clinical practice of diagnostic and
interventional cardiology in pediatric and congenital heart
disease. In the organization of this book, a combination of
procedure-based and problem-based approaches has been employed. The
structure of the book has been updated to make it more reader
friendly, chapters have been added to address new techniques and
problems in the field, and greater emphasis has been placed on
evaluation of outcomes of transcatheter interventions in congenital
heart disease. Section 1 covers the fundamentals of cardiac
catheterization, with chapters devoted to pre-procedure patient
evaluation, sedation and anesthesia, vascular access and related
issues, catheterization equipment ands its use, hemodynamic
evaluation, angiography, radiation and radiation safety, and
echocardiography in the catheterization lab. Sections 2 through 4
include procedure-based chapters that are organized according to
the technical type of intervention. Section 2 is devoted to
transcatheter interventions for obstructive lesions, including
valvar stenoses and vascular obstructions. Section 3 includes
chapters that cover interventions to close various pathologic
intracardiac communications and vascular anomalies. Section 4
includes chapters covering interventions performed to create or
enlarge intracardiac communications, as well as other
interventions. Section 5 focuses on the applications of
catheterization and transcatheter interventions in the evaluation
and management of specific patient populations. This problem-based
or patient-based focus, which is substantially expanded from the
previous edition of the book, reflects the expanding role of
catheterization in the comprehensive management of pediatric and
congenital heart disease, and addresses emerging applications of
transcatheter interventions, including management of the patient
receiving extracorporeal circulatory support, hybrid
transcatheter-surgical interventions, and prenatal cardiac
intervention. Section 6 includes two chapters that cover outcome
assessment and regulatory issues pertinent to the pediatric
cardiology in general and interventional cardiology in particular.
General
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