Current Practice Scope of catheter based interventions in paediatric cardiology

Interventional cardiology is a catheter based treatment modality for non surgical treatment of certain cardiac defects through venous and arterial access to restore normal or near normal haemodynamics. Before 1980, lesions which required interventions were either surgically palliated or corrected. Although the first successful paediatric intervention, balloon atrial septostomy by Rashkind and Miller was performed in 1966 1, the era of paediatric intervention really began with pulmonary balloon valvuloplasty by Kan et al in 1982 2. Since then there have been explosive developments in this field and it is now possible to deal with a multitude of paediatric cardiac lesions through transvenous approach. The goals of such interventions should be safety, effectiveness and wide applicability with clinically acceptable results. More than half of all paediatric catheterisations are now related to interventional procedures and it has become a crucial aspect in the management of children with heart disease. Catheter techniques have become the accepted and preferred curative therapy for many acyanotic congenital heart defects. This tremendous development is mainly due to two reasons. First is the availability of better imaging modalities in the form of echocardiography (transthoracic, transoesophageal, intracardiac). Second is the innovation and refinement of hardware used in interventions such as catheters, guidewires, coils, devices, percutaneous valves and stents. In this respect the efforts made to achieve clinical excellence by clinicians and researchers have gone a long way in the development of the field. Advantages of interventions over surgery are minimal anaesthetic complications, absence of sternotomy or thoracotomy related complications, n