The use of balloon-tipped catheters for the treatment of cardiac malformations was initiated by Rashkind and Miller, with the introduction of the atrial septostomy catheter in 1966 (1 ). This was an important historical milestone because it was the first therapeutic interventional procedure performed in the cardiac catheterization laboratory. Since its introduction balloon atrial septostomy continues to be of major importance for the non-surgical creation of an atrial septal defect in neonates with inadequate mixing of pulmonary and systemic venous blood at atrial leveL The use of catheters for dilatation of peripheral artery stenosis was reported previously by Dotter and Judkins in 1964 (2). Almost a decade passed before the next major step in therapeutic cardiac catheterization was made. In 197 4 Giiintzig reported the use of small cylindrical high pressure balloons for the dilatation of atherosclerotic arteries (3). In 1982 Kan and coworkers reported the use of large balloon catheters for the treatment of congenital valvular pulmonary stenosis (4). In the following years many reports on the use of balloon dilatation catheters for the treatment of obstructive cardiovascular lesions in children were published (5 - 20). These lesions included valvular stenosis as well as stenosed veins and arteries. Since then, balloon valvuloplasty and angioplasty have been applied both for native stenoses, and for residual or recurrent stenotic lesions after surgery

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Financial support by the Sophia Foundation for Medical Research and the Netherlands Heart Foundation for the preparation and publication of this thesis is gratefully acknowledged
J. Hess (Jakob)
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam