Pharmacologie cardiovasculaire : libre accès

Abstrait

Catheter Interventions for Congenital Heart Disease with Less and Less Radiation

Ian C Gilchrist

Percutaneous intervention for inborn cardiopathy (CHD) has been established as a core treatment modality since Rashkind pioneered balloon septostomy for neonates with transposition of the nice arteries. Since then, internal organ catheterization has progressed from principally being a process to interventions within the majority of cases, particularly as an outsized quantity of diagnostic data will be obtained with imaging modalities, like diagnostic procedure, X-radiation and magnetic resonance imaging. Tube interventions for CHD (as well as for coronary disease) area unit historically performed beneath fluoroscopic steering mistreatment radiation. Particularly in pediatric apply, any use of radiation carries the potential risk of DNA harm and also the development of malignancy years to decades once the procedure. Hence, the ‘as low as moderately achievable’ principle has been introduced, and efforts are created to attenuate the dose used for common interventions. This will be expedited by elaborated visual image of advanced anatomy with imaging modalities, like magnetic resonance imaging, before intervention. Such preprocedural designing permits preselection of the angulations required for interventional X-ray photography, thence decreasing procedure time and minimizing distinction and radiation load. Diagnostic procedure and X-ray photography don't invariably correlate well, as shown for infant arterial valves. Hence, in these cases, X-ray photography because the gold customary to work out balloon size cannot be replaced by diagnostic procedure. Image fusion could be a technique within which preexistent magnetic resonance imaging or X-radiation pictures area unit overlaid on the live fluoroscopic pictures and area unit used as a ‘road map’ to guide tube interventions (i.e., in coarctation of the aorta).