Pediatric and congenital therapeutic cardiac catheterization.

T he concept that a catheter could be used for intracardiac therapy was first put into practice in 19641 with the dilation of acquired peripheral vascular stenosis by graduated rigid dilators. Isolated cases of intracardiac therapy with a catheter had appeared as early as 19532; however, the balloon atrial septostomy developed by Dr. Rashkind and reported in 19663 was the first pediatric and the first intracardiac therapeutic procedure with a catheter to be used as a routine form of therapy. This extremely innovative yet relatively crude procedure rapidly became the standard emergency therapy for the newborn with transposition of the great arteries. The balloon atrial septostomy not only proved lifesaving for hundreds of critically ill infants, but the procedure established that successful therapy could and should be accomplished with a catheter. In doing so, the Rashkind procedure also stimulated the imagination of other investigators in the field of catheter therapeutics.