CRITICAL PULMONARY VALVE STENOSIS IN THE NEONATE - A TECHNIQUE TO FACILITATE BALLOON DILATION

Critical pulmonary valve stenosis associated with ductal dependent pulmonary blood flow is rare, accounting for a small proportion of all infants undergoing balloon dilatation.1 Valvuloplasty in these infants may be technically difficult and at times impossible due to inability to traverse the critically stenotic valve. Previous investigators have described a gradational approach whereby balloon catheters of increasing diameter (2, 4, 6, 8 and 10 mm) are sequentially advanced and inflated across the valve relieving the obstruction.2 This approach, however, is time consuming and subjects the infant to prolonged fluoroscopy exposure. We have developed a valvuloplasty technique in the neonate with critical pulmonary valve stenosis which shortens fluoroscopy time and facilitates catheter advancement across the critically stenotic valve. © 1994.