[Recent viewpoints on the examination and therapy of infants and children with congenital cardiovascular defects]. / Neuere Gesichtspunkte bei der Untersuchung und Behandlung von Säuglingen und Kindern mit angeborenen Herz- und Gefässanomalien.

ABSTRACT

Basic methods for the examination including echocardiography are described. Indications for cardiac catheterization, angiography, and a description of the risk of these invasive methods are given. Cardiac catheterisation is necessary as early as possible in all cyanotic infants who are suspected to have heart defects - even in newborns. In transposition of the great arteries the hemodynamics can be improved by balloon septostomy during the first days of life. After septostomy the children can be operated upon during the second half of the first year of life. Non-cyanotic infants with an uncertain diagnosis or recurrent or medically not treatable heart failure have to be examined to clarify the need for an operation. Generally, early operative correction during the first year of life is the best, even more so with unsuccessful - medical treatment. This is valid especially for children with ventricular septal defects, although up to 60% of them tend to close spontaneously. Early correction almost always prevents obstructive pulmonary vascular disease. In contrast in aortic stenosis, cases for operative treatment should be carefully selected. Only critical stenoses have to be operated on very early. To choose the right time for operation and thereby save the childrens life it is necessary to be sure of an intensive and continuous follow-up by a pediatric cardiologist in all children with congenital heart disease.