Review Article| Volume 26, P89-97, 2023

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Catheter-based Interventions to Reduce or Modify Surgical Risk in High-Risk Adult Congenital Heart Disease Patients

  • Weiyi Tan
    Address correspondence to: Weiyi Tan, MD, MPH, Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Adult Congenital Heart Disease, 2001 Inwood Rd, West Campus Building 3, 5th Floor, Dallas, TX, 75390.
    Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Adult Congenital Heart Disease, Dallas, Texas
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  • Jamil Aboulhosn
    Division of Cardiology, Department of Medicine, University of California Los Angeles, Adult Congenital Heart Disease, Los Angeles, California
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Published:February 02, 2023DOI:
      The field of adult congenital heart disease has changed greatly over the past sixty years. As patients are now surviving longer into adulthood due to various improvements in surgical technique and medical technology, the demographic of patients with congenital heart disease (CHD) has changed, such that there are now more adults with CHD than there are children with CHD. This older and more medically complex population needs more interventions to treat residual defects or sequelae of their initial surgeries, and many of these patients are now deemed high risk for surgery. When the surgical risk becomes too great, either due to patient complexity, surgical complexity, or both, then transcatheter procedures may have a role in either mitigating or avoiding the risk altogether.


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        • Gilboa SM
        • Devine OJ
        • Kucik JE
        • et al.
        Congenital heart defects in the United States: Estimating the magnitude of the Affected Population in 2010.
        Circulation. 2016; 134: 101-109
        • Tan W
        • Stefanescu Schmidt AC
        • Horlick E
        • et al.
        Transcatheter interventions in patients with adult congenital heart disease.
        J Soc Cardiovasc Angiogr Interv [Internet]. 2022; 100438
        • Maurer SJ
        • Bauer UMM
        • Baumgartner H
        • et al.
        Acquired comorbidities in adults with congenital heart disease: An analysis of the German National Register for congenital heart defects.
        J Clin Med. 2021; 10: 1-10
        • Agarwal A
        • Thombley R
        • Broberg CS
        • et al.
        Age- and lesion-related comorbidity burden among US adults with congenital heart disease: A population-based study.
        J Am Heart Assoc. 2019; 8: 1-11
        • Constantine A
        • Costola G
        • Bianchi P
        • et al.
        Enhanced assessment of perioperative mortality risk in adults with congenital heart disease.
        J Am Coll Cardiol. 2021; 78: 234-242
        • Fuller SM
        • He X
        • Jacobs JP
        • et al.
        Estimating mortality risk for adult congenital heart surgery : An analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database.
        Ann Thorac Surg [Internet]. 2015; 100: 1728-1736
        • Kan JS
        • White RI
        • Mitchell SE
        • et al.
        Percutaneous balloon valvuloplasty: A new method for treating congenital pulmonary-valve stenosis.
        N Engl J Med [Internet]. 1982; 307 (Available from) (Accessed 8/15/22): 540-542
        • McCrindle BW.
        Independent predictors of long-term results after balloon pulmonary valvuloplasty.
        Circulation. 1994; 89: 1751-1759
        • Stout KK
        • Daniels CJ
        • Aboulhosn JA
        • et al.
        2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.
        J Am Coll Cardiol [Internet]. 2019; 73: e81-192
        • Du ZD
        • Hijazi ZM
        • Kleinman CS
        • et al.
        Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: Results of a multicenter nonrandomized trial.
        J Am Coll Cardiol [Internet]. 2002; 39: 1836-1844
        • Yang J
        • Yang L
        • Wan Y
        • et al.
        Transcatheter device closure of perimembranous ventricular septal defects : Mid-term outcomes.
        Eur Heart J. 2010; 31: 2238-2245
        • Forbes TJ
        • Kim DW
        • Du W
        • et al.
        Comparison of surgical, stent, and balloon angioplasty treatment of native coarctation of the aorta: An observational study by the CCISC (Congenital cardiovascular interventional study consortium).
        J Am Coll Cardiol. 2011; 58: 2664-2674
        • Bradley EA
        • Cai A
        • Cheatham SL
        • et al.
        Mustard baffle obstruction and leak - How successful are percutaneous interventions in adults?.
        Prog Pediatr Cardiol [Internet]. 2015; 39 (Pt BAvailable from) (Accessed 8/15/22): 157-163
        • Mets JM
        • Bergersen L
        • Mayer JE
        • et al.
        Outcomes of stent implantation for obstruction of intracardiac lateral tunnel Fontan pathways.
        Circ Cardiovasc Interv. 2013; 6: 92-100
        • Serfas JD
        • Thibault D
        • Andersen ND
        • et al.
        The evolving surgical burden of fontan failure: an analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database.
        Ann Thorac Surg [Internet]. 2021; 112: 179-187
        • Rosenthal E
        • Qureshi SA
        • Jones M
        • et al.
        Correction of sinus venosus atrial septal defects with the 10 zig covered Cheatham-platinum stent - An international registry.
        Catheter Cardiovasc Interv [Internet]. 2021; 98 (Available from) (Accessed 8/15/22): 128-136
        • Silini A
        • Iriart X.
        Percutaneous edge-to-edge repair in congenital heart disease: Preliminary results of a promising new technique.
        Int J Cardiol Congenit Hear Dis [Internet]. 2022; 8100370
        • Nomoto R
        • Sleeper LA
        • Borisuk MJ
        • et al.
        Outcome and performance of bioprosthetic pulmonary valve replacement in patients with congenital heart disease.
        J Thorac Cardiovasc Surg [Internet]. 2016; 152 (Available from): 1333-1342.e3
        • Khairy P
        • Aboulhosn J
        • Gurvitz MZ
        • et al.
        Arrhythmia burden in adults with surgically repaired tetralogy of fallot: A multi-institutional study.
        Circulation. 2010; 122: 868-875
        • McElhinney DB
        • Zhang Y
        • Levi DS
        • et al.
        Reintervention and survival after transcatheter pulmonary valve replacement.
        J Am Coll Cardiol. 2022; 79: 18-32
        • Elkayam U
        • Bansal P
        • Mehra A.
        Catheter-based interventions for the management of valvular heart disease during pregnancy.
        JACC Adv [Internet]. 2022; 1100022
        • Banka P
        • Sleeper LA
        • Atz AM
        • et al.
        Practice variability and outcomes of coil embolization of aortopulmonary collaterals before fontan completion: A report from the Pediatric Heart Network Fontan Cross-Sectional Study.
        Am Heart J [Internet]. 2011; 162: 125-130
        • Tan W
        • Reardon L
        • Lin J
        • et al.
        Occlusion of aortopulmonary and venovenous collaterals prior to heart or combined heart-liver transplantation in Fontan patients: A single-center experience.
        Int J Cardiol Congenit Hear Dis [Internet]. 2021; 6100260
        • Nwaejike N
        • Mills K
        • Stables R
        • et al.
        Balloon aortic valvuloplasty as a bridge to aortic valve surgery for severe aortic stenosis.
        Interact Cardiovasc Thorac Surg. 2015; 20: 429-435
        • Avgerinos DV.
        • Dayal R
        • Mack C
        • et al.
        Staged endovascular repair of aortic coarctation followed by double valve surgery.
        Aorta. 2021; : 178-180
        • Porras D
        • Gurvitz M
        • Marshall AC
        • et al.
        Hybrid approach for off-pump pulmonary valve replacement in patients with a dilated right ventricular outflow tract.
        Ann Thorac Surg [Internet]. 2015; 100: e99-101
        • Lau M
        • Chan DTL
        • Bhatia I
        • et al.
        Hybrid approach for cerebral protection in open-heart surgery: Case series.
        J Card Surg. 2022; 37: 2727-2731
        • Sosnowski C
        • Matella T
        • Fogg L
        • et al.
        Hybrid pulmonary artery plication followed by transcatheter pulmonary valve replacement: Comparison with surgical PVR.
        Catheter Cardiovasc Interv. 2016; 88: 804-810
        • Nijenhuis VJ
        • Swaans MJ
        • Post MC
        • et al.
        Open transapical approach to transcatheter paravalvular leakage closure: A preliminary experience.
        Circ Cardiovasc Interv. 2014; 7: 611-620
        • Holmes DR
        • Rich JB
        • Zoghbi WA
        • et al.
        The heart team of cardiovascular care.
        J Am Coll Cardiol [Internet]. 2013; 61: 903-907