Balloon pulmonary valvuloplasty in neonates with critical pu
Critical pulmonary stenosis (PS) is one of the life-threatening congenital heart diseases which present during the neonatal period with cyanosis. Surgical valvotomy was once the procedure of choice for critical PS; however, balloon pulmonary valvuloplasty (BPV) has now become the standard treatment. Although the procedure is usually simple, crossing the pulmonary valve from the femoral vein can be difficult, especially when severe tricuspid regurgitation and right atrium dilatation are present. In such patients, the maneuver can be simplified by using the right internal jugular vein approach. However, many operators are reluctant to use this approach because of unfamiliarity with the technique, potential complications, and paucity of reports. In this study a comparison of transjugular with the transfemoral approach in terms of procedure time and complications.

Of 15 neonates undergoing BPV, eight were done using the transjugular approach and seven using the femoral approach. The mean age and weight in both groups were similar. In all eight patients using a transjugular approach, crossing the pulmonary valve was consistently quick and easy. The total procedural time, pulmonary crossing time, and fluoro time was significantly shorter using the transjugular approach. There were no complications relating to vascular access. Moreover, the BPV procedure itself demonstrated comparable results in both groups. Conclusively, Shorter procedural time and low rate of complication make the transjugular approach a better choice for BPV procedure in critical PS. Most importantly, it can minimize radiation exposure to patients.