Pediatric interventional cardiology: a specialty comes of age.

Pediatric intervcntional cardiology was conceived in the 1960s by Dr. William Rashkind, emerged as a distinct suhspccialty during the 198Os, and has come of age in the 1990s. At C.S. Mott Children’s Hospital, the number of interventional pediatric cardiac catheterizations has grown rapidly during the past decade (Fig. 1). Therapeutic procedures currently comprise 35%-40% of all cardiac catheterizations performed at our center. Interventional cardiac catheterization offers a wide array of catheter-based procedures to treat congenital or acquired cardiovascular disease in patients from the newborn period to adulthood (Table l). Percutaneous balloon dilation is the treatment of choice for congenital pulmonary or aortic valve stenosis, and provides effective therapy for many children with pulmonary artery stenosis or coarctation of the aorta (native or recurrent). In addition to dilation procedures, implantable devices are available to treat a variety of congenital or acquired cardiovascular anomalies. Balloon-expandable stents have improved our capacity to care for many children with pulmonary artery stcnosis or hypoplasia. Embolization coils are used to occlude the small-to-moderate patent ductus arteriosus, aortopulmonary collateral vessels, and surgical shunts. Umbrella type devices continue to undergo clinical investigation to evaluate their potential to treat secundum atrial septal defects, muscular ventricular septal defects, and the patent ductus arteriosus. Of course, radiofrequency ablation has revolutionized the treatment of children with arrhythmias supported by accessory pathways or ectopic foci. This