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Interventional catheterization procedures

Since October 2002, a wide variety of interventional catheterization procedures are being routinely performed at the Heart Center. These include closure of septal defects and other unwanted shunts, balloon dilation of stenoses in the vascular system, and stent implantation in selected stenotic vessels in patients of all ages. In a large proportion of these patients, catheter intervention leads to definitive therapy, without the requirement for a surgical procedure. In addition we routinely perform pecutaneous catheter ablation procedures for the entire range of cardiac arrhythmias seen in children and young adults, using either radiofrequency current or cryoablation. Curative catheter ablation avoids the need for long-term pharmacologic therapy in children.

Closure of atrial and ventricular septal defects

A variety of closure devices are routinely utilised for percutaneous closure of septal defects. The type of device used and the device size depends on the size and location of the defect that needs to be closed. After accurate positioning of the device, aided both by routine transoesophageal echocardiography and radiographic screening, the device can be released. Complete control over the device (allowing safe removal in case the device is deemed unsuitable for an individual defect) is maintained by the operator throughout the procedure. Transcatheter closure of ASDs and arterial ducts can at present be performed safely and successfully within a matter of a few minutes. Complete endothelialisation of the implanted device occurs within 6 months following the procedure.

Between 70 and 80% of secundum ASDs can be closed with a device. In the remainder, for various reasons such as defect size (very large defect with inadequate rims for safe anchoring of the closure device) open heart surgery may still be required.

Percutaneous ablation therapy for cardiac arrhythmias

This is at present routinely performed in children, in the majority of whom, until recently, long-term pharmacological therapy remained the first choice. With improved understanding of tachyarrhythmia mechanisms and increasing experience, ablation in children is both safe and effective. Such procedures are currently performed every week in children with tachyarrhythmias; the procedure is painless and is performed under general anaesthesia. 

Adults with congenital heart disease (Grown up Congenital Heart Disease – GUCH)
We offer a dedicated interdisciplinary working group, consisting of paediatric and adult cardiologists and cardiac surgeons with expertise in the management of adults with congenital heart disease. At our routine conferences, we discuss and plan the optimal management of such patients.

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