Early Experience with Pediatric Cardiac Intervention in Songklanagarind Hospital
Worakan Promphan, MD*, Somkiat Sopontammarak, MD*, Somrit Jantarapratin, MD**
Affiliation : * Department of Pediatrics, Faculty of Medicine, Prince of Songkhla University, Songkla ** Bangkok-Hat Yai Hospital, Songkla
Background : Nowadays, pediatric cardiac intervention is an effective optional treatment for congenital
heart disease (CHD). Several cardiac centers have been established in different regions of Thailand and
Songklanagarind Hospital is the newest of these university cardiac centers.
Objective : To report results and complications of transcatheter treatment for congenital cardiac defects in
Songklanagarind Hospital.
Materials and Methods : The medical database was reviewed for the results and complications of different
types of pediatric cardiac intervention from May, 2000 to December, 2003.
Results : There were 102 cases of pediatric cardiac intervention. Sixty-seven were patent ductus arteriosus
(PDA), 16 were valvular pulmonary stenosis (VPS), 10 were cyanotic CHD which needed balloon atrial
septostomy (BAS), 8 were abnormal aorto-pulmonary (AP) collaterals, and 1 was severe valvular aortic
stenosis (VAS). Coil embolization was performed in 53 patients with PDA and 8 patients with AP-collateral
vessels, 32 of PDAs (60.4%) and all AP-collateral vessels (100%) were completely obliterated within 24
hours. The Amplatzer duct occluder (ADO) was deployed in 14 PDAs with 100% completely obliteration
within 24 hours. In those with VPS or VAS, percutaneous balloon valvuloplasty (PBV) was the treatment of
choice. The mean peak to peak systolic pressure gradient in VPS was reduced from 62.8 + 33.3 mmHg to
33.33 + 33.33 mmHg and from 76 mmHg to 49 mmHg in VAS after the procedures. In BAS, the mean diameter
of atrial communication increased from 3.0 + 0.7 mm to 5.9 + 0.4 mm. In coil embolization, 8 had distal PA
embolization (15%), 1 had hemolysis (2%) and 1 had decreased dorsalis pedis pulse (2%). One (7%) of the
ADO-implanted patients had a weak femoral pulse. Of the VPS cases, 1 died from intractable heart failure,
and 1 developed hemiparesis, from which they completely recovered within 6 months. The patient with VAS
had a femoral artery complication.
Conclusion : Pediatric cardiac intervention in Songklanagarind Hospital has satisfactory results with an
acceptable complication rate.
Keywords : Pediatric cardiac intervention, Congenital heart disease
