Document Detail

Ascending aortic approach for balloon aortic valvuloplasty with concomitant bilateral pulmonary artery banding in a very low-birth-weight neonate with critical aortic stenosis and poor left ventricular function.
MedLine Citation:
PMID:  21636284     Owner:  NLM     Status:  MEDLINE    
An 1186-g infant was born at 27 weeks' gestation. Echocardiography showed critical aortic stenosis, a dilated left ventricle (left ventricular end-diastolic diameter, 16.9 mm), and poor left ventricular function (left ventricular ejection fraction, 8.5%). Due to duct-dependent systemic circulation, the patient underwent a hybrid intervention consisting of bilateral pulmonary artery banding (PAB) and balloon aortic valvuloplasty (BAV) via the ascending aorta on day 2. A stainless steel tip and a 6-French introducer were combined to create an access device. The access device was inserted into the ascending aorta, through which balloon catheters were manipulated. On day 4, echocardiography showed a left ventricular ejection fraction of 48% and dominant antegrade blood flow in the aortic arch. The pulmonary artery bands were removed and the ductus was clipped on day 8 to establish in-line circulation. After re-balloon aortic valvuloplasty for restenosis, the patient was discharged from the hospital at 7 months of age. The clinical implications of this case are: the ascending aortic approach is feasible for BAV in low-birth-weight neonates; and bilateral PAB performed concomitantly with BAV may be efficient for neonates with critical aortic stenosis and poor left ventricular function.
Mitsutoshi Kimura; Yasushi Misaki; Hitoshi Kato; Yukihiro Kaneko
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  41     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-03-01     Completed Date:  2012-05-01     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  226-8     Citation Subset:  IM    
Division of Cardiovascular Surgery, National Medical Center for Children and Mothers, Tokyo, Japan.
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MeSH Terms
Aortic Valve Stenosis / complications,  diagnosis,  therapy*
Birth Weight
Catheterization / methods*
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / diagnosis,  therapy*
Infant, Very Low Birth Weight
Pulmonary Artery / surgery*
Ventricular Dysfunction, Left / complications,  diagnosis,  therapy*

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