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Balloon occlusion aortography
T Ino1, S Shimazaki, K Nishimoto
1Department of Paediatrics, Juntendo University School of Medicine, Tokyo, Japan.
Insights
Balloon occlusion aortography (BOA) is a safe and effective imaging technique for congenital heart disease in infants. While generally successful, precise visualization may require selective angiography in older children.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Interventional Radiology
Background:
- Congenital heart disease necessitates advanced diagnostic imaging.
- Balloon occlusion aortography (BOA) is an interventional technique with potential applications in pediatric cardiology.
Purpose of the Study:
- To evaluate the diagnostic validity and safety of balloon occlusion aortography (BOA) in infants and children with congenital heart disease.
- To assess the utility of BOA for imaging the aortic arch, pulmonary arteries, and coronary arteries.
Main Methods:
- Retrospective review of 18 patients with congenital heart disease undergoing BOA.
- Procedures included aortic arch, pulmonary, and coronary arteriography using balloon occlusion techniques.
- Patient cohort included neonates and infants with varying congenital heart defects.
Main Results:
- Diagnostic information was satisfactory in 17 out of 18 patients (94.4%).
- BOA successfully visualized the aortic arch, pulmonary arteries, and coronary arteries in most pediatric patients.
- One case of pulmonary artery under-visualization occurred due to complex hemodynamics.
Conclusions:
- Balloon occlusion aortography is a safe and valuable diagnostic tool for evaluating congenital heart disease in infants.
- For children over 3 years, selective angiography may be preferred due to potential difficulties in aortic occlusion.
- BOA offers a reliable method for detailed vascular imaging in complex pediatric cardiac cases.
Abstract:
We review the validity of balloon occlusion aortography (BOA) on the basis of our personal experience with 18 patients with congenital heart disease (mean weight 4.55 g, including 8 neonates). Four of the 18 patients underwent aortic arch angiography using balloon occlusion of the descending aorta. Pulmonary angiography was also performed in 9 patients via a patent ductus arteriosus and in 3 patients via a Blalock-Taussig shunt. The remaining 2 patients underwent coronary arteriography by balloon occlusion of the ascending aorta. The information obtained was satisfactory in 17 of the 18 patients. However, in one patient with a double-outlet right ventricle and pulmonary stenosis, the pulmonary arteries were not clearly visualized because of dominant antegrade flow from the right ventricle. BOA is a safe and useful procedure which can be used to image the aortic arch, pulmonary artery, and coronary arteries in infants with congenital heart diseases. In children over 3 years of age, however, the balloon may not be able to occlude the appropriate site of the aorta, so selective angiography is required to obtain precise information.