日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

As a result of advanced noninvasive imaging such as echocardiography, computed tomography, and magnetic resonance imaging, pediatric catheterization laboratories are now increasingly being used for therapeutic procedures. Diagnostic catheterization is no longer indicated during the routine preoperative evaluation of most congenital heart diseases. Indications for diagnostic catheterization are as follows: (1) when accurate physiological measurements are required including severity assessment of aortic or mitral stenosis or feasibility studies for a Fontan operation, (2) when the anatomic features are poorly visualized by noninvasive imaging, (3) when therapeutic procedures are planned, (4) when hemodynamic assessment is critical (to determine the presence of pulmonary vascular disease), or (5) when electrophysiological studies or biopsies are required. Thus, diagnostic catheterization still serves as the gold standard for anatomical and physiological assessment of patients with congenital heart disease, particularly for those with complex congenital heart diseases. This review will discuss the acquisition and interpretation of intravascular pressure, oxygen saturation, and angiographic images.