Congenital Heart Disease

This practical manual provides a comprehensive overview of how the cardiac catheterization laboratory in a pediatric cardiology division works. Chapters are organized in the order in which a case progresses. Hemodynamics is covered in depth. This manual provides a comprehensive overview of how the cardiac catheterization laboratory in a pediatric cardiology division works. Chapters are organized in the order in which a case progresses. Specific types of cases are discussed in detail and hemodynamics is covered in depth. Information tables and line illustrations are used throughout the text to further emphasize important concepts and information. Lisa Bergersen, M.D. is affiliated with the Children's Hospital Boston, Department of Cardiology, Boston, MA. Susan Foerster, M.D. is affiliated with the St. Louis Children's Hospital, Division of Cardiology, St. Louis, MO. Audrey C. Marshall, M.D. is affiliated with the Children's Hospital Boston, Department of Cardiology, Boston, MA. Jeffery Meadows, M.D. is affiliated with the University of California, San Francisco Medical Center, San Francisco, CA. Procedure and Techniques The aortic valve in these patients is most often The dilation can be approached from either a myxomatous and bicuspid with a single, fused retrograde or antegrade direction. Remember commissure and an eccentrically placed orifice, that critical AS is a case of millimeters-so you or unicuspid (dome-shaped). The valve annulus need to be meticulous. may be small for age, but there is evidence that following dilation even quite small annuli may grow to a normal or near normal dimension (1). Retrograde Approach Myxomatous valves may mature, as Myxo- tous pulmonary valves. Because there is a spec- This is the more common approach at Children's trum to left-sided obstructive lesions, often the Hospital Boston since the production of l- first decision in many of these patients is whether profile balloons. Often the umbilical artery and they should have a valvotomy or a staged o- vein already have been cannulated, and may be ventricle repair.