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The Management of Three Infants with Critical Valvular Aortic Stenosis by Transcarotid Balloon Aortic Balvuloplasty

Journal of the Korean Pediatric Society 2000;43(6):820-827.
Published online June 15, 2000.
The Management of Three Infants with Critical Valvular Aortic Stenosis by Transcarotid Balloon Aortic Balvuloplasty
Kie-Young Park1, Young-Hwue Kim1, Ji-Yeon Min1, Jae-Kon Ko1, In-Sook Park1, Chang-Yee Hong1, Tae-Jin Yun2, Dong-Man Seo2
1Department of Pediatrics, College of Medicine Ulsan University, Asan Medical Center, Seoul, Korea
2Department of Surgery, College of Medicine Ulsan University, Asan Medical Center, Seoul, Korea
영아에서 심부전 증상을 보인 심한 대동맥판 협착에서 경동맥을 이용한 풍선 성형술 치료 3례
박기영1, 김영휘1, 민지연1, 고재곤1, 박인숙1, 홍창의1, 윤태진2, 서동만2
1울산대학교 의과대학 서울중앙병원 소아과
2울산대학교 의과대학 서울중앙병원 흉부외과
Abstract
Critical valvular aortic stenosis(AS) is a life threatening congenital heart anomaly in neonates or infants. The main cause of death is rapidly progressing left ventricular failure. The treatment goal of critical AS is to save left ventricular function early. Before the 1980s, the preferred treatment was surgical valvotomy, however, that operative method had a high mortality rate and risk of reprocedure. These surgical problems encouraged balloon aortic valvuloplasty technique for initial life saving. There were some vascular approaches for balloon aortic valvuloplasty(e.g. femoral artery and vein, umbilical artery and vein, carotid artery). Each approach has some advantages and disadvantages. Balloon aortic valvuloplasty through the right carotid artery makes access to the aortic valve easy, has less vascular complication, and short procedure time and effect of saving femoral artery for reballooning. We had three cases of transcarotid balloon aortic valvuloplasty in infants with critical AS. In our long-term follow up, we had good results, except carotid artery thrombosis in one case. We report the first three Korean cases of balloon aortic valvuloplasty though carotid artery cutdown procedure for critical AS with a brief review of literatures.
Key Words: Critical valvular aortic stenosis, Transcarotid balloon aortic valvuloplasty


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