Transcatheter balloon valvuloplasty in critical infantile aortic and pulmonary stenosis is difficult. Mortality with AS is as high as 25%. Hence many centers prefer surgery.
Aim: to evaluate the success of balloon valvuloplasty in infants with coronary hardware.
Material & Methods: Out of 175 cases of ABV, 11 were infants (6.3%). Out of 365 of PBV, 44 were infants (12%).Aortic valve was successfully crossed in all with Shinobi 0.014 x 180 guide wire with hydrophilic coating and radio opaque tip. Pulmonary valves were crossed with high torque floppy 0.014 x 190 guide wire, with loop in RA. Dilatation done with 1.5, 2.5, 4mm PTCA balloons and 6mm Tyshak balloons.
Results: ABV was successful in all cases. Youngest, 14 hours old hydrops foetalis neonate on ventilator. Echo showed pin point critical AS with EF-30%, gradient 36 mm Hg, post ABV with 4mm PTCA balloon, EF improved to 60%, after 48 hours neonate was off ventilator. 1.8 kgs, 2 days old, was youngest case of PS . 8 cases of TOF with severe hypoxemia with mean SO2 – 48 + 8 %. After PBV, SO2 improved to 85 + 5%. PV peak Grdt. – 100 + 2 came down to 24 + 6 mm Hg. Successful in all cases with only one mortality ( 1.8 %) . Loss of femoral pulse in 2 cases.
Conclusions; BV though riskiest and demanding is literally life saving in infants. Usage of better hardware and PTCA balloons have significantly reduced the morbidity and mortality in infants.