Balloon aortic valvuloplasty for congenital aortic stenosis using the femoral and the carotid artery approach: A 16‐year experience from a single center

Abstract

Percutaneous intervention for relief of critical aortic stenosis in newborns in a tertiary center of a developing country is safe and has excellent short and long-term results comparable to other centers throughout the world.

Percutaneous Common Carotid Artery Access for Pediatric Interventional Cardiac Catheterization

“…Furthermore, the miniaturization of sheaths and balloon catheters over time could bias older reports of carotid cutdown toward lower carotid patency rates because of the larger sheath sizes that were previously required. Although some contemporary studies of carotid cutdown exist, 1,19 these provide almost no carotid follow-up imaging. In our series, PCA resulted in a carotid patency rate of 95% at last available follow-up, including 5 carotid arteries that were accessed twice.…”

Severe Aortic Stenosis and Severe Coarctation of the Aorta: A Hybrid Approach to Treatment

“…This procedure traditionally was performed using the femoral artery, however, carotid and axillary cutdown is now being used with more success and less complications. Rossi and the group from Porto Alegre in Brazil found rates of femoral arterial occlusion as high as 40% (6). Over a 16-year period, a clear leg length discrepancy was observed in one patient (6).…”

Neonatal Interventions for Left-Sided Obstructive Lesions

“…Studies reporting the use of carotid artery access via a surgical cut down have shown a low risk of vascular complications when compared with femoral arterial access. 19 No neurologic sequelae were seen in these studies and the carotid arteries were patent after repair. 19,33 Significant aortic insufficiency after balloon dilation has been reported to occur in 1% to 31% of neonates.…”

“…19 No neurologic sequelae were seen in these studies and the carotid arteries were patent after repair. 19,33 Significant aortic insufficiency after balloon dilation has been reported to occur in 1% to 31% of neonates. 31,[34][35][36] Moderate to severe insufficiency is a risk factor for surgical re-intervention 35,37 and progression of the severity of aortic insufficiency over time has been documented.…”

“…Potential complications are listed in Box 2. Acute vascular damage is the most frequently reported complication seen in neonates, with femoral artery occlusion and loss of pulse being reported in up to 43% of procedures 19 in contemporary series. However, a more recent review of more than 1000 patients undergoing balloon dilation reported an overall complication rate of 15% from 334 neonatal procedures.…”