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Balloon valvuloplasty for critical aortic stenosis in two infants
Ming-Chih Lin1, Yun-Ching Fu, Sheng-Ling Jan
1Department of Pediatrics, Taichung Veterans General Hospital, 160, Sec. 3, Chung-Kang Road, Taichung 407, Taiwan.
Insights
Transcatheter balloon valvuloplasty effectively treats critical aortic valve stenosis in infants. This minimally invasive procedure offers a safe alternative to surgery, improving patient outcomes.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Critical aortic valve stenosis (AS) presents significant challenges in neonates and young infants, necessitating prompt intervention for survival.
- Supportive medical care alone is insufficient; relieving the stenosis is paramount for improving patient prognosis.
Observation:
- Two cases of critical AS in infants managed with transcatheter balloon valvuloplasty are presented.
- Case 1: A 2-month-old female with cardiopulmonary failure underwent aortic valve dilation (6mm then 8mm balloon), reducing the pressure gradient from 83 to 13 mmHg.
- Case 2: A 7-day-old male underwent aortic valve dilation (6mm balloon), reducing the pressure gradient from 87 to 44 mmHg.
Findings:
- Both infants tolerated the balloon valvuloplasty procedure well, with no major complications reported.
- A transient weak femoral pulse was the only noted complication in one patient.
- The procedure demonstrated significant reduction in aortic pressure gradients in both critical AS cases.
Implications:
- Transcatheter balloon valvuloplasty appears to be a safe and effective therapeutic option for critical AS in young infants.
- Advantages include avoidance of cardiopulmonary bypass and general anesthesia, shorter hospital stays, and reduced need for blood products.
- This technique offers a less invasive approach, potentially leading to better patient tolerance and recovery without scarring.
Abstract:
Critical aortic valve stenosis (AS) is a difficult clinical condition. Besides supportive medical care, relief of the stenosis is most important to the patients' survival. We present two cases using transcatheter balloon valvuloplasty in managing critical AS in young infants. Case 1 was a 2 month-old female infant. She presented with cardiopulmonary failure. Aortic annulus was 8 mm and the aortic valve was dilated with a 6 mm and then an 8 mm diameter balloon. The pressure gradient was reduced from 83 to 13 mmHg. Case 2 was a 7 day-old male infant. Aortic annulus was 6.7 mm and the aortic valve was dilated with a 6 mm diameter balloon. The pressure gradient was reduced from 87 to 44 mmHg. Both patients tolerated the procedure well. No major complications developed except that a transient weak femoral pulse was noted in case 1. In our limited experience, balloon valvuloplasty is a safe and effective therapeutic choice for managing critical AS in young infants. The advantages include no need of bypass or general anesthesia, shortened hospital course, reduced exposure to blood product, and no scar.
