Transcatheter Interventions in Infants With Congenital Heart Disease: A Two-Year Retrospective Case Series From a Tertiary Centre in India.

BACKGROUND

Severe forms of congenital heart disease (CHD) remain a leading cause of neonatal morbidity and mortality. In recent decades, transcatheter interventions have emerged as a less invasive, repeatable, and effective alternative to surgical treatment, particularly for critically ill neonates.

OBJECTIVE

This retrospective study evaluates the demographic characteristics, diagnoses, procedures, complications, and 30-day outcomes of infants undergoing transcatheter interventions for CHD at Geetanjali Medical College and Hospital, Udaipur, Rajasthan, between December 2021 and November 2023.

METHODS

Of 108 infants admitted with CHD during the study period, 28 underwent transcatheter interventions. Patients managed surgically or medically, or whose parents declined intervention, were excluded.

RESULTS

Transcatheter interventions were successfully performed in 28 infants with CHD over two years (2021-2023). Acyanotic CHD (n = 9) included seven patent ductus arteriosus (PDA) and two ventricular septal defect (VSD) device closures (median age = 11 months, median weight = 6 kg) with 100% procedural success and 30-day survival. Patients with obstructive CHD (n = 5) underwent balloon pulmonary valvotomy and coarctoplasty (median age = 5 months, median weight = 5.6 kg), achieving universal success and 100% 30-day survival. Patients with cyanotic CHD (n = 14) received balloon atrial septostomy (n = 5), right ventricular outflow tract stenting (n = 2), and PDA stenting (n = 7) with 93% success; one PDA stenting failure occurred alongside two cases of arrhythmias, with 50% 30-day survival cumulatively.

CONCLUSION

Transcatheter interventions are a potentially valuable modality for safe and effective definitive or bridge to definitive treatment of infants with CHD, especially in resource-limited settings. These procedures may play a vital role in bridging the gap in paediatric cardiac care.