Anterograde Transvenous Balloon Angioplasty of Recurrent Coarctation in Infancy

Balloon angioplasty of a severe recurrent coarctation was performed in a 4-month-old injant using an anterograde approach not previously described for this lesion. The entire procedure was performed transvenously. After transseptal entry into the left atrium, the transseptal sheath was placed across the mitral valve and the angioplasty catheter advanced across the recurrent coarctation. Angioplasty reduced the systolic gradient from 65 mmHg to 22 mmHg, without acute complications. W e feel that the anterograde transvenous approach should be considered as an alternative to retrograde transarterial angioplasty in infancy, since femoral artery injury is avoided. ( J Interven Cardiol 1988:1:2)