All issues > Volume 43(6); 2000

Case Report

J Korean Pediatr Soc. 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 KY Park¹, Young-Hwue YH Kim¹, Ji-Yeon JY Min¹, Jae-Kon JK Ko¹, In-Sook IS Park¹, Chang-Yee CY Hong¹, Tae-Jin TJ Yun², Dong-Man DM 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

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.

Keywords :Critical valvular aortic stenosis, Transcarotid balloon aortic valvuloplasty