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Title: Evolutie van de indicaties voor hartkatheterisatie bij kinderen
Author(s): DE WOLF D, SUYS B, FRANÇOIS K, DE GROOTE K, VERHAAREN H, TAEYMANS Y, MATTHYS D
Journal: Tijdschrift voor Geneeskunde
Volume: 58    Issue: 20   Date: 2002   
Pages: 1341-1349
DOI: 10.2143/TVG.58.20.5001445

Abstract :
Tot einde jaren zestig was hartkatheterisatie een deel van het diagnostisch arsenaal van de kindercardioloog. Sinds de introductie van de atriale ballonseptostomie van Rashkind in 1966 werd ook de therapeutische rol van hartkatheterisatie steeds belangrijker.
Interventionele of therapeutische hartkatheterisaties spelen thans een belangrijke rol in de behandeling en de palliatie van hartafwijkingen. Steeds meer aangeboren hartaandoeningen worden met interventionele technieken behandelbaar. Verfijning van het materiaal laat nu ook bij pasgeborenen veilige interventies toe en de toenemende betrouwbaarheid van de technieken vergroot de mogelijkheden van opname in daghospitalisatie.





Heart catheterisation in children: evolution of indications
Until the end of the sixties, heart catheterisation was an important diagnostic tool for the assessment of children with congenital heart disease. Since William Rashkind introduced balloon atrial septostomy for the palliation of newborns with transposition of the great arteries, heart catherisation became also part of the therapeutic tools of the pediatric cardiologist.
Therapeutic or interventional catheterisations can be classified according to the expected results: curative or, palliative for simple lesions and palliative for more complex lesions.
Balloon dilatation of pulmonary valve stenosis, device closure of patent ductus arteriosus and probably umbrella closure of atrial septal defect have become the treatment of choice in the first category. For the second group, balloon dilatation of aortic valve stenosis and coarctation (eventually accompanied by stent implantation) are accepted as a valuable treatment. Many techniques are used for the palliation of complex congenital heart diseases, most of them only in small numbers. Stent implantation in peripheral pulmonary artery stenosis is the most promising.
Meanwhile, continuous technical improvements allow safe interventions in newborns and a more accurate approach of complex diseases, in so far that the numbers of interventional heart catheterisations exceed those of diagnostic catheterisations in most centres dealing with congenital heart disease.

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