Transcatheter Interventions in Infants With Congenital Heart Disease: A Two-Year Retrospective Case Series From a Tertiary Centre in India

Background: Severe forms of congenital heart disease (CHD) remain a leading cause of neonatal morbidity and mortality. In recent decades, transcatheter interventions have emerged as a less invasive, repeatable, and effective alternative to surgical treatment, particularly for critically ill neonates. Objective: This retrospective study evaluates the demographic characteristics, diagnoses, procedures, complications, and 30-day outcomes of infants undergoing transcatheter interventions for CHD at Geetanjali Medical College and Hospital, Udaipur, Rajasthan, between December 2021 and November 2023. Methods: Of 108 infants admitted with CHD during the study period, 28 underwent transcatheter interventions. Patients managed surgically or medically, or whose parents declined intervention, were excluded. Results: Transcatheter interventions were successfully performed in 28 infants with CHD over two years (2021-2023). Acyanotic CHD (n = 9) included seven patent ductus arteriosus (PDA) and two ventricular septal defect (VSD) device closures (median age = 11 months, median weight = 6 kg) with 100% procedural success and 30-day survival. Patients with obstructive CHD (n = 5) underwent balloon pulmonary valvotomy and coarctoplasty (median age = 5 months, median weight = 5.6 kg), achieving universal success and 100% 30-day survival. Patients with cyanotic CHD (n = 14) received balloon atrial septostomy (n = 5), right ventricular outflow tract stenting (n = 2), and PDA stenting (n = 7) with 93% success; one PDA stenting failure occurred alongside two cases of arrhythmias, with 50% 30-day survival cumulatively. Conclusion: Transcatheter interventions are a potentially valuable modality for safe and effective definitive or bridge to definitive treatment of infants with CHD, especially in resource-limited settings. These procedures may play a vital role in bridging the gap in paediatric cardiac care.