JACC Focus Seminar: Issues in Congenital Heart Disease
JACC Review Topic of the Week
Transcatheter Intervention for Congenital Defects Involving the Great Vessels: JACC Review Topic of the Week

https://doi.org/10.1016/j.jacc.2020.11.019Get rights and content
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Highlights

  • Transcatheter methods have become the standard approach to the management of many congenital anomalies involving the great vessels.

  • Balloon angioplasty and stent implantation are key components of catheter-based interventions for these lesions.

  • Techniques, risks, and outcomes differ substantially across therapeutic approaches to aortic and pulmonary artery lesions.

  • Ongoing innovation and technological advancements will facilitate transcatheter treatment options for a broader array of congenital anomalies involving the great vessels.

Abstract

Since the development of balloon angioplasty and balloon-expandable endovascular stent technology in the 1970s and 1980s, percutaneous transcatheter intervention has emerged as a mainstay of therapy for congenital heart disease (CHD) lesions throughout the systemic and pulmonary vascular beds. Congenital lesions of the great vessels, including the aorta, pulmonary arteries, and patent ductus arteriosus, are each amenable to transcatheter intervention throughout the lifespan, from neonate to adult. In many cases, on-label devices now exist to facilitate these therapies. In this review, we seek to describe the contemporary approach to and outcomes from transcatheter management of major CHD lesions of the great vessels, with a focus on coarctation of the aorta, single- or multiple-branch pulmonary artery stenoses, and persistent patent ductus arteriosus. We further comment on the future of transcatheter therapies for these CHD lesions.

Key Words

coarctation of the aorta
congenital heart disease
interventional cardiology
patent ductus arteriosus
pulmonary artery stenosis

Abbreviations and Acronyms

AE
adverse event
BA
balloon angioplasty
CB
cutting balloon
CHD
congenital heart disease
CoA
coarctation of the aorta
CP
Cheatham Platinum
PA
pulmonary artery
PAS
pulmonary artery stenosis
PDA
patent ductus arteriosus
RV
right ventricle
SI
stent implantation
TOF
tetralogy of Fallot

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