The treatment of congenital or acquired heart defects by transcatheter therapy has crossed a period of rapid expansion in the last 10 years and is now an important adjunct to surgery. Balloon valvuloplasty can be considered as the treatment of choice for pulmonic and aortic congenital valvar stenosis as well as closure of a patent ductus arteriosus. The short hospital stay and absence of a scar make this approach very attractive. With the introduction of new techniques and devices, transcatheter therapy has become common for a number of other anomalies such as the atrial septal defect and soon some ventricular septal defects. It is necessary to maintain careful indications and compare the results with conventional surgery in order to assess the risks and benefits of these new techniques.