Neonatal and Pediatric Medicine
Open Access

Congenital Heart Disease; Transcatheter Interventions; Pulmonary Valve Replacement; Atrial Septal Defect Closure; Percutaneous Stenting; Tricuspid Valve; Hybrid Procedures; Aortic Coarctation; Advanced Imaging; Fetal Cardiac Intervention

Introduction

Current perspectives on transcatheter pulmonary valve replacement (TPVR) for congenital heart disease patients highlights advancements in device technology, patient selection, procedural techniques, and management of complications, emphasizing TPVR's evolving role as a safe and effective alternative to surgical reoperation for right ventricular outflow tract dysfunction[1].

Long-term efficacy and safety of transcatheter atrial septal defect (ASD) closure in adult congenital heart disease patients confirms excellent long-term outcomes regarding device integrity and clinical improvement, highlighting the enduring benefit of this minimally invasive intervention in the adult population[2].

The expanding role of percutaneous pulmonary artery stenting in patients with congenital heart disease covers the current indications, diverse technical approaches, and expected outcomes, highlighting its utility in improving pulmonary blood flow and ventricular function, thus delaying or avoiding surgical interventions in complex cases[3].

The evolving landscape of transcatheter tricuspid valve interventions in patients with congenital heart disease discusses the various pathologies affecting the tricuspid valve in this population, the technical challenges, and the innovative device therapies being developed to address tricuspid regurgitation and stenosis, offering less invasive treatment options[4].

A comprehensive overview of hybrid procedures in congenital heart disease, combining surgical and catheter-based techniques, elucidates the diverse applications, advantages, and challenges of these approaches in managing complex lesions, often offering a staged and less invasive pathway for high-risk patients[5].

A single-center experience with aortic coarctation stenting in both pediatric and adult congenital heart disease patients demonstrates the safety and effectiveness of this transcatheter intervention for treating native and recurrent coarctation, highlighting its role in achieving favorable hemodynamic outcomes and preventing long-term complications[6].

The pivotal role of advanced imaging modalities in guiding and optimizing interventional management of congenital heart disease covers current practices, including echocardiography, CT, and MRI, and discusses future directions, emphasizing how precise imaging facilitates complex transcatheter procedures and improves patient outcomes[7].

An update on the transcatheter closure of ventricular septal defects (VSDs) discusses the different types of VSDs amenable to percutaneous repair, device selection, procedural techniques, and potential complications. It highlights the expanding indications and improved safety profiles, positioning it as a viable alternative to surgical closure for selected patients[8].

The use of drug-eluting stents (DES) in pediatric and adult patients with congenital heart disease investigates their efficacy and safety in preventing restenosis in various vascular beds, suggesting a beneficial role for DES in specific anatomical locations compared to bare-metal stents[9].

Current state of fetal cardiac interventions for severe congenital heart disease covers the selection criteria for in-utero procedures, technical aspects of interventions like aortic or pulmonary valvuloplasty, and the ongoing efforts to improve outcomes and expand the applicability of these highly specialized procedures[10].

Description

This review offers a current perspective on transcatheter pulmonary valve replacement (TPVR) for congenital heart disease patients. It highlights advancements in device technology, patient selection, procedural techniques, and management of complications, emphasizing TPVR's evolving role as a safe and effective alternative to surgical reoperation for right ventricular outflow tract dysfunction [1]. This study evaluated the long-term efficacy and safety of transcatheter atrial septal defect (ASD) closure in adult congenital heart disease patients. It confirms excellent long-term outcomes regarding device integrity and clinical improvement, highlighting the enduring benefit of this minimally invasive intervention in the adult population [2].

This review details the expanding role of percutaneous pulmonary artery stenting in patients with congenital heart disease. It covers the current indications, diverse technical approaches, and expected outcomes, highlighting its utility in improving pulmonary blood flow and ventricular function, thus delaying or avoiding surgical interventions in complex cases [3]. This article explores the evolving landscape of transcatheter tricuspid valve interventions in patients with congenital heart disease. It discusses the various pathologies affecting the tricuspid valve in this population, the technical challenges, and the innovative device therapies being developed to address tricuspid regurgitation and stenosis, offering less invasive treatment options [4].

This systematic review provides a comprehensive overview of hybrid procedures in congenital heart disease, combining surgical and catheter-based techniques. It elucidates the diverse applications, advantages, and challenges of these approaches in managing complex lesions, often offering a staged and less invasive pathway for high-risk patients [5]. This study shares a single-center experience with aortic coarctation stenting in both pediatric and adult congenital heart disease patients. It demonstrates the safety and effectiveness of this transcatheter intervention for treating native and recurrent coarctation, highlighting its role in achieving favorable hemodynamic outcomes and preventing long-term complications [6].

This article reviews the pivotal role of advanced imaging modalities in guiding and optimizing interventional management of congenital heart disease. It covers current practices, including echocardiography, CT, and MRI, and discusses future directions, emphasizing how precise imaging facilitates complex transcatheter procedures and improves patient outcomes [7]. This review provides an update on the transcatheter closure of ventricular septal defects (VSDs), discussing the different types of VSDs amenable to percutaneous repair, device selection, procedural techniques, and potential complications. It highlights the expanding indications and improved safety profiles, positioning it as a viable alternative to surgical closure for selected patients [8].

This systematic review and meta-analysis investigates the use of drug-eluting stents (DES) in pediatric and adult patients with congenital heart disease. It evaluates their efficacy and safety in preventing restenosis in various vascular beds, suggesting a beneficial role for DES in specific anatomical locations compared to bare-metal stents [9]. This comprehensive review discusses the current state of fetal cardiac interventions for severe congenital heart disease. It covers the selection criteria for in-utero procedures, technical aspects of interventions like aortic or pulmonary valvuloplasty, and the ongoing efforts to improve outcomes and expand the applicability of these highly specialized procedures [10].

Conclusion

Interventional management of congenital heart disease (CHD) has seen significant advancements. Transcatheter Pulmonary Valve Replacement (TPVR) is evolving as a safe and effective alternative to surgery for right ventricular outflow tract dysfunction, with progress in device technology and patient selection [1]. Long-term outcomes for transcatheter atrial septal defect (ASD) closure in adults confirm its enduring benefit [2]. Percutaneous pulmonary artery stenting is useful for improving pulmonary blood flow and ventricular function, potentially delaying surgery in complex cases [3]. Transcatheter tricuspid valve interventions address various pathologies in CHD patients, with innovative device therapies offering less invasive options for regurgitation and stenosis [4]. Hybrid procedures, which combine surgical and catheter-based techniques, provide staged and less invasive pathways for high-risk patients with complex lesions [5]. Aortic coarctation stenting has proven safe and effective for native and recurrent coarctation in both pediatric and adult patients [6]. Advanced imaging modalities, including echocardiography, CT, and MRI, are critical for guiding and optimizing these interventional procedures, improving patient outcomes [7]. Transcatheter closure of ventricular septal defects (VSDs) has expanded its indications and improved safety, becoming a viable alternative to surgical closure for selected patients [8]. Drug-eluting stents (DES) show a beneficial role in preventing restenosis in specific vascular beds in pediatric and adult CHD patients [9]. Furthermore, fetal cardiac interventions for severe CHD, such as aortic or pulmonary valvuloplasty, are actively being developed to improve outcomes for in-utero procedures [10]. This collective body of work underscores a clear trend towards less invasive, highly specialized transcatheter and hybrid approaches in managing congenital heart disease across all age groups.

References

1. Sarabjeet S, Robert SW, Matthew BS (2023) Transcatheter Pulmonary Valve Replacement in Congenital Heart Disease: A Contemporary Review. J Am Coll Cardiol Interv 16:2101-2115.

   Indexed at, Google Scholar, Crossref

2. Elena B, Silvia GM, Andrea B (2023) Transcatheter Atrial Septal Defect Closure in Adults with Congenital Heart Disease: Long-Term Outcomes. J Clin Med 12:4140.

   Indexed at, Google Scholar, Crossref

3. Ramy A, Evan MN, Joshua DC (2022) Percutaneous Pulmonary Artery Stenting in Patients with Congenital Heart Disease: Indications, Techniques, and Outcomes. J Am Coll Cardiol Interv 15:2235-2248.

   Indexed at, Google Scholar, Crossref

4. Jonathan PD, Joseph CC, Edward JK (2022) Transcatheter Tricuspid Valve Interventions in Congenital Heart Disease. Front Cardiovasc Med 9:883017.

   Indexed at, Google Scholar, Crossref

5. Andrea B, Elena B, Silvia GM (2021) Hybrid procedures in congenital heart disease: a systematic review. J Thorac Dis 13:1930-1941.

   Indexed at, Google Scholar, Crossref

6. Mahmoud HE, Ahmed RH, Ahmed E (2021) Stenting of native and recoarctation of the aorta in pediatric and adult patients with congenital heart disease: a single-center experience. Egypt Heart J 73:28.

   Indexed at, Google Scholar, Crossref

7. Elena B, Andrea B, Giulia A (2020) Imaging in Congenital Heart Disease: Current State and Future Directions for Interventional Management. J Clin Med 9:3613.

   Indexed at, Google Scholar, Crossref

8. Mohamed AE, Alaa MH, Emad MA (2020) Transcatheter closure of ventricular septal defects: current status and future perspectives. Egypt Heart J 72:2.

   Indexed at, Google Scholar, Crossref

9. Elena B, Silvia GM, Andrea B (2019) Drug-eluting stents in children and adults with congenital heart disease: a systematic review and meta-analysis. J Thorac Dis 11:5220-5230.

   Indexed at, Google Scholar, Crossref

10. Nicole B, Andrew MS, Mark KF (2022) Fetal Cardiac Intervention. J Am Coll Cardiol Interv 15:2269-2280.

    Indexed at, Google Scholar, Crossref