Antegrade balloon valvuloplasty for critical aortic stenosis in a premature neonate weighing 1100 g

Experiences with invasive cardiac catheterization in low birth weight infants are few. In our clinic, we performed balloon aortic valvuloplasty by antegrade approach in a neonate weighing 1100 g with critical aortic stenosis, patent ductus arteriosus and atrial septal defect. The right femoral vein was accessed with a 4 Fr sheath, and a catheter was placed into the left ventricle from the atrial septal defect along the guidewire for coronary catheter. The aortic valve was passed with guidewire, and the guidewire was placed into the right arteria carotis. After proper placement, the balloon was inflated at 6 atm using an indeflator device until indentation disappeared. After the procedure, the mean pressure gradient over the stenotic aortic valve was measured as 18 mmHg, mild-moderate aortic insufficiency was noticed, and left ventricle contraction was better. To the best of our knowledge, this is the lowest weight infant in the literature to undergo successful antegrade balloon aortic valvuloplasty.