Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-04T17:32:26.375Z Has data issue: false hasContentIssue false

Balloon dilation of neonatal critical aortic valvar stenosis via the umbilical artery

Published online by Cambridge University Press:  16 April 2009

Tomaž Podnar*
Affiliation:
Department of Paediatrics, University Medical Centre Ljubljana, Slovenia
Pavel Berden
Affiliation:
Department of Radiology, University Medical Centre Ljubljana, Slovenia
Samo Vesel
Affiliation:
Department of Paediatrics, University Medical Centre Ljubljana, Slovenia
*
Correspondence to: Dr Tomaž Podnar, University Medical Centre Ljubljana, Department of Paediatrics, Vrazov trg 1, 1525 Ljubljana, Slovenia. Tel: +386 1 5229 332; Fax: +386 1 5229 357; E-mail: [email protected]

Abstract

Objectives

To report our experience with balloon dilation of critical aortic valvar stenosis in neonates via the umbilical artery using currently available catheters.

Background

There is no agreement regarding the optimal vascular approach for balloon dilation of critical aortic valvar stenosis in neonates.

Methods

Since June of 2005, we have attempted to obtain umbilical arterial access within the first week after birth in all neonates with critical aortic valvar stenosis. In patients in whom umbilical artery access was obtained, we proceeded with an attempt at balloon dilation.

Results

We were presented with 5 patients with critical aortic valvar stenosis within the first week after birth, and the umbilical arterial approach was obtained in all, with effective relief of the stenosis achieved in 4.

Conclusions

The umbilical arterial approach should always be considered for balloon dilation of neonatal critical aortic valvar stenosis. Using currently available catheters, the procedure is safe, simple, and effective even in patients weighing less than 2.5 kilograms. Further experience using this approach is warranted.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Wren, C, Sullivan, I, Bull, C, Deanfield, J. Percutaneous balloon dilatation of aortic valve stenosis in neonates and infants. Br Heart J 1987; 58: 608612.CrossRefGoogle ScholarPubMed
2. Kasten-Sportes, CH, Piechaud, JF, Sidi, D, Kachaner, J. Percutaneous balloon valvuloplasty in neonates with critical aortic stenosis. J Am Coll Cardiol 1989; 13: 11011105.CrossRefGoogle ScholarPubMed
3. Weber, HS. Catheter management of aortic valve stenosis in neonates and children. Catheter Cardiovasc Interv 2006; 67: 947955.CrossRefGoogle ScholarPubMed
4. Beekman, RH, Rocchini, AP, Andes, A. Balloon valvuloplasty for critical aortic stenosis in the newborn: influence of new catheter technology. J Am Coll Cardiol 1991; 17: 11721176.CrossRefGoogle ScholarPubMed
5. Egito, EST, Moore, P, O’Sullivan, J, et al. Transvascular balloon dilation for neonatal critical aortic stenosis: early and midterm results. J Am Coll Cardiol 1997; 29: 442447.CrossRefGoogle ScholarPubMed
6. Kim, DW, Raviele, AA, Vincent, RN. Use of a 3 French system for balloon aortic valvuloplasty in infants. Catheter Cardiovasc Interv 2005; 66: 254257.CrossRefGoogle ScholarPubMed
7. Magee, AG, Nykanen, D, McCrindle, BW, Wax, D, Freedom, RM, Benson, LN. Balloon dilation of severe aortic stenosis in the neonate: comparison of antegrade and retrograde catheter approaches. J Am Coll Cardiol 1997; 30: 10611066.CrossRefGoogle Scholar
8. Fischer, DR, Ettedgui, JA, Park, SC, Siewers, RD, del Nido, PJ. Carotid artery approach for balloon dilation of aortic valve stenosis in the neonate: a preliminary report. J Am Coll Cardiol 1990; 15: 16331636.CrossRefGoogle ScholarPubMed
9. Weber, HS, Mart, CR, Myers, JL. Transcarotid balloon valvuloplasty for critical aortic valve stenosis at the bedside via continuous transesophageal echocardiographic guidance. Catheter Cardiovasc Interv 2000; 50: 326329.3.0.CO;2-T>CrossRefGoogle ScholarPubMed