J Korean Pediatr Soc.
2000 Jun;43(6):820-827.
The Management of Three Infants with Critical Valvular Aortic Stenosis by
Transcarotid Balloon Aortic Valvuloplasty
Abstract
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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 re- procedure. 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.
(J Korean Pediatr Soc 2000;43:820-827)