Glossary of Childhood Onset Heart Disease
Based upon the needs and
requests of our readers, we have created this glossary to
provide accurate and concise information for families and
individuals. The following represents a "work in
progress". Please contact
us to submit items you would like to see included on this
page.
Cath Lab Procedures
The risks and possible complications of these
procedures vary from patient to patient, and should be
discussed with your (child's) practitioner.
Ablation ("RFA" or radiofrequency
ablation)
The use of high frequency radio waves directly on the
electrical system of the heart. Ablation can be used to
eliminate abnormal sites of electrical activity in the
heart that may cause arrhythmias. For many forms of
arrhythmias, ablation is highly successful, and is the
treatment of choice for certain types of rapid
tachyarhythmias (palpitations) such as supraventricular
tachycardia (SVT).
Balloon Atrial Septostomy
This is a procedure done in newborns,
either in the cardiac catheterization laboratory or under
echocardiographic guidance at the bedside. Typically,
this procedure is performed in babies with Transposition
of the Great Vessels who have very low levels of oxygen
in the blood.
In a balloon atrial septostomy (BAS), a
catheter (tube) with a large balloon on the end, is
passed from either the vein in the leg, or via the
umbilical vein to the heart. The catheter is then
manipulated through a small hole between the top two
chambers of the heart which is present in all children.
It is the inadequate size of this hole that causes the
low oxygen levels in the babies with Transposition. Once
the catheter is through the hole to the left atrium, the
balloon is inflated, and the catheter is forcefully
pulled back through the small hole, tearing open a larger
hole between the two chambers. This usually results in an
immediate increase in oxygen blood levels. In some cases,
this procedure can be life-saving, allowing the baby time
to undergo surgical repair of the Transposition. This
procedure has extremely low risks in experienced hands.
Balloon Bag Occlusion
An interventional catheterization technique used to close
abnormal vessels. A bag is attached to a catheter and
filled with coils. The bag is placed in the abnormal
vessel and once the vessel is documented to be closed,
the bag full of coils is released from the catheter and
remains in place inside the patient. Usually,
anticoagulants are necessary for only a short period of
time (e.g. 6 months).
Balloon Valvuloplasty (Valve Dilation)
An interventional catheterization technique where an
uninflated balloon is placed across a narrowed valve
inside the heart. The balloon is inflated while situated
across the narrowed valve increasing the area available
for blood flow, and decreasing the degree of obstruction.
Nearly all balloon valve dilations result in some degree
of leakage (regurgitation) of the valve following
the procedure.
Click here
for additional information
Balloon Angioplasty (Blood Vessel Dilation)
An invasive catheterization procedure where a narrowed
portion of a blood vessel (e.g., coarctation of the
aorta, pulmonary artery stenosis) is enlarged by
inflating a balloon which enlarges the narrowed segment.
Severe coarctations of the aorta or pulmonary artery
narrowings resemble an hourglass. The balloon dilation
intentionally tears part of the wall of the blood vessel.
Rarely, the vessel may rupture or an aneurysm may form,
requiring surgical repair
Coil Embolization
The release of curled metal coils into abnormal blood
vessels, resulting in non-surgical closure of these
structures. Usually, anticoagulants are neessary for only
a short period of time (e.g. 6 months).
Coil Occlusion of PDA (Patent Ductus
Arteriosus)
A nonsurgical (but invasive) catheterization procedure
where small, thin metal coils are placed through a
catheter to close an unwanted communication between the
aorta and pulmonary artery.
Click
here for additional
information
Grifka-Gianturco Sac (for PDA occlusion)
An experimental device used to close larger PDA’s or
collateral vessels. A detachable sac that is filled with
coils is attached to a catheter and placed directly in
the PDA (or collateral vessel). An additional coil holds
the sac in stable position in the unwanted blood vessel,
and the sac is detached and released. The sac fills the
blood vessel and stops the blood flow.
Click
here for additional
information
Heart Biopsy
A procedure performed in the cardiac
catheterization laboratory under x-ray guidance. A
catheter (tube) is passed to the right ventricle (right
lower chamber of the heart) from either the large vein in
the neck (internal jugular vein) or from the groin
(femoral vein). This special tube has "pincers"
(small jaws) on its end that can be opened and closed
from outside of the patient. When the catheter is
positioned properly against the wall that separates the
right and left lower chambers, the jaws are opened,
pushed up against the wall, and closed taking a tiny
"bite" of tissue from the heart muscle. This is
usually repeated 4 – 6 times, allowing the muscle to
be studied under the microscope by a pathologist.
This procedure is most often performed
in children who have undergone heart transplantation to
screen for and assess the severity of rejection. It is
also used for children who may need a diagnosis when they
present to the cardiologist with poorly functioning heart
muscle. In these cases, infections of the heart muscle,
and genetic abnormalities can be diagnosed.
Interventional Cardiology
A relatively new field whereby traditional surgical
procedures are performed during a heart catheterization.
These procedures include opening narrowed areas with
balloons and stents, closing unwanted vessels with coils
or intravascular devices, and ablation for unwanted
rhythm problems.
Occlusion Devices (atrial and ventricular
septal defect occluders)
A number of investigators are designing devices which can
be delivered through a catheter to close holes in the
upper chambers (ASDs) and lower chambers (VSDs). Although
a number have been successfully used in clinical trials
supervised by the Food and Drug Administration, the
follow-up is necessarily quite short at this time.
Click
here for additional information
Stents (endovascular, endobronchial, or
tracheal)
Cylindrical metal devices which areplaced on a balloon
catheter, and are used to enlarge narrowed areas of blood
vessels or the airway. When expanded, stents have the
appearance of a "chicken wire" cylinder, and
resist collapsing. When non-expanded, the stents are long
and thin. Endobronchial stents are used inside the
airways(trachea) and endovascular stents can be used in
blood vessels (pulmonary arteries or veins, major
systemic veins, atrial baffles, or coarctation of the
aorta).
Transhepatic Catheterization
Literally, "through the liver"
catheterization. Cardiac catheterization in children
almost always requires placing a catheter in one of the
large veins of the body (neck or groin most often). In
some children who have had multiple heart surgeries,
frequent catheterizations, or have required long-term
catheter therapy (antibiotics, intravenous nutrition,
kidney dialysis), these large veins may be obstructed.
In these patients further catheter
therapy can be difficult or impossible. Using a
relatively new technique, a large vein of the liver can
be entered using methods very similar to those used for
the neck or the groin veins. Once the catheter is in the
vein, there is no difference between this approach or any
other. Upon removing the catheter, there is a small
chance of bleeding into the belly. Most physicians who
perform this procedure, therefore, use small coils
(plugs) to close the hole in the liver before the
catheter is completely removed. There is no known
long-term effect on the liver.
- Other Articles in This Section
- Associated Conditions
- Cath Lab Procedures
- Imaging Techniques
- Medical Personnel
/Services
- New Strategies /
Techniques
- Surgical Complications
- Surgical Procedures
Your feedback is very important! Please e-mail
us with any questions or comments about this article.
Return to Resource Room.
|
