CAROTID-ARTERY APPROACH TO BALLOON AORTIC VALVULOPLASTY IN INFANTS WITH CRITICAL AORTIC-VALVE STENOSIS

We compare the clinical efficacy of two approaches for balloon aortic valvuloplasty (BAV) in infants with critical aortic valve stenosis. Th e approaches were through the carotid artery and the femoral artery. E ight catheterizations for BAV were performed in seven consecutive pati ents with critical aortic stenosis: four BAVs were approached through the femoral artery and four through the right common carotid artery. W e inserted a 5F sheath into the right common carotid artery by a cutdo wn procedure; after BAV the sheath was removed and the carotid arterio tomy sutured with 7-0 monofilament. Two cases in which the femoral art ery approach was used resulted in failure to perform BAV; two cases ha d complications. All four cases with the carotid artery approach were successful, with no complications; aortography performed 3 months afte r one balloon valvuloplasty revealed a smooth, unobstructed right caro tid artery. Use of the carotid artery approach may reduce serious comp lications with BAV and offers quicker, easier maneuvering in infants a nd neonates with critical aortic valve stenosis.