Right internal jugular vein approach as an alternative in balloon pulmonary valvuloplasty

Abstract

Transjugular balloon pulmonary valvuloplasty was safely and successfully performed in five patients, two of whom had severe right heart failure. Crossing the stenotic pulmonary valve from the right internal jugular vein was consistently easy and quick. This approach should be considered whenever difficulties are experienced or anticipated in the femoral approach. Cathet. Cardiovasc. Intervent. 46:425–429, 1999. © 1999 Wiley‐Liss, Inc.

An unconventional valvuloplasty: severe pulmonary stenosis with 'candy cane' inferior vena cava

“…Backward traction shortened the wire loop rather than preventing distal balloon slippage, unlike infemoral approach. This difficulty was also faced by Joseph et al in their series,5 but as proposed by them, taking a longer balloon size or a stiffer balloon type was not a feasible option in our small-sized patient.…”

“…Transjugular balloon dilation of the PV5 and the PA6 has since been reported. Rarely, transaxillary7 and transhepatic8 approaches have been used for BPV.…”

Transjugular Balloon Pulmonary Valvuloplasty Through a Bidirectional Glenn Shunt for Dysplastic Pulmonary Valve Stenosis in an 8.7-Year-Old Boy with Inaccessible Femoral Veins

“…Transjugular BPV or balloon angioplasty has rarely been reported in patients with pulmonary valve/artery stenosis. Reluctance of cardiologists to perform transjugular BPV or angioplasty may be due to unfamiliarity with the landmark of the internal jugular vein, the technique of balloon floating maneuver, 7 potential complication by inserting larger catheters and sheaths into smaller patients, and anecdotal reports of transjugular cardiac catheterization. Ultrasound-aided cannulation of the internal jugular vein may be a preferred technique to improve success rate, decrease access time, and substantially reduce complication rates.…”

Transjugular approach to concurrent mitral-aortic and mitral-tricuspid balloon valvuloplasty

“…The right internal jugular vein can be cannulated easily and reliably and can serve as a safe conduit for large balloon catheters in children and adults [1][2][3]19]. These benefits, combined with the ease of crossing the pulmonary valve with a balloon floatation catheter from the jugular vein, have been utilized in pulmonary valvuloplasty and angioplasty of peripheral pulmonary artery stenosis [1,2,19]. Jugular venous access has also been used for transseptal mitral valvuloplasty in adults [3].…”

“…A transjugular approach to percutaneous balloon valvuloplasty is feasible and advantageous in certain cases of congenital valvar pulmonary stenosis [1,2] and rheumatic mitral stenosis [3]. During pulmonary valvuloplasty, the right internal jugular vein approach simplifies pulmonary valve crossing in patients with severe pulmonary valvar stenosis and right heart failure [1,2]. In transvenous mitral valvuloplasty, the jugular approach simplifies septal puncture and mitral valve crossing in patients with huge left atrium and distorted anatomy, besides making the procedure feasible in the presence of inferior vena caval obstruction [3].…”