Balloon and blade atrial septostomy facilitated by two-dimensional echocardiography

Lin, Angela E.; Sessa, T; Williams, Roberta G.; Leighton, John; Gross, Karen; Wong, Ah Lin

doi:10.1016/0002-9149(86)90904-5

Cited by 27 publications

(11 citation statements)

References 7 publications

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“…In lifesaving situations the procedure can be done in the intensive care unit under echocardiographic guidance. 52,[55][56][57][58][59][60][61][62][63][64][65][66] Although balloon atrial septostomy is usually a safe procedure, complications have been reported. Transient rhythm disturbances are frequent 67 ; on rare occasions they can be permanent or fatal.…”

Section: Opening Of Atrial Communications Balloon Atrial Septostomymentioning

confidence: 99%

Pediatric Therapeutic Cardiac Catheterization

Allen¹,

Beekman²,

Garson³

et al. 1998

Circulation

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Section: Opening Of Atrial Communications Balloon Atrial Septostomymentioning

confidence: 99%

Pediatric Therapeutic Cardiac Catheterization

Allen¹,

Beekman²,

Garson³

et al. 1998

Circulation

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“…Long-term use is associated with cortical hyperostosis, an effect that does not seem to be dose related. Monitoring in an intensive care unit is therefore, advised18). Although there is no CHD for which PGE 1 is contraindicated, obstructed TAPVR and TGA with a restrictive atrial septum may exacerbate with PGE 1 2,10).…”

Section: Managementmentioning

confidence: 99%

“…After inflating the balloon, it is pulled back into the right atrium, to tear the friable atrial septum, and if the final diameter of ASD is more than 5 mm, and flap motion of the inferior rim of the atrial septum increases and increase in the oxygen saturation is noted, the procedure is satisfactory18,19). This is an effective and safe procedure for creating long lasting adequate interatrial communications.…”

Section: Managementmentioning

confidence: 99%

Congenital heart disease in the newborn requiring early intervention

Yun

2011

Korean J Pediatr

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Although antenatal diagnostic technique has considerably improved, precise detection and proper management of the neonate with congenital heart disease (CHD) is always a great concern to pediatricians. Congenital cardiac malformations vary from benign to serious conditions such as complete transposition of the great arteries (TGA), critical pulmonary and aortic valvular stenosis/atresia, hypoplastic left heart syndrome (HLHS), obstructed total anomalous pulmonary venous return (TAPVR), which the baby needs immediate diagnosis and management for survival. Unfortunately, these life threatening heart diseases may not have obvious evidence early after birth, most of the clinical and physical findings are nonspecific and vague, which makes the diagnosis difficult. High index of suspicion and astute acumen are essential to decision making. When patent ductus arteriosus (PDA) is opened widely, many serious malformations may not be noticed easily in the early life, but would progress as severe acidosis/shock/cyanosis or even death as PDA constricts after few hours to days. Ductus dependent congenital cardiac lesions can be divided into the ductus dependent systemic or pulmonary disease, but physiologically quite different from each other and treatment strategy has to be tailored to the clinical status and cardiac malformations. Inevitably early presentation is often regarded as a medical emergency. Differential diagnosis with inborn error metabolic disorders, neonatal sepsis, persistent pulmonary hypertension of the newborn (PPHN) and other pulmonary conditions are necessary. Urgent identification of the newborn at such high risk requires timely referral to a pediatric cardiologist, and timely intervention is the key in reducing mortality and morbidity. This following review deals with the clinical presentations, investigative modalities and approach to management of congenital cardiac malformations presenting in the early life.

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“…This technique is usually satisfactory for most neonates less than 2 weeks and not more than 4 weeks old. Beyond that age, the interatrial septum (IAS) is considered too thick or tough for this method [9,11,13], which instead requires blade atrial septostomy [1,12,18,19,21] or surgical atrial septectomy [5]. Blade atrial septostomy requires a more skillful hand and has some associated morbidity and mortality.…”

mentioning

confidence: 99%

Balloon Atrial Septostomy Under Two-Dimensional Echocardiographic Control: A New Outlook

Jamjureeruk¹,

Sangtawesin²,

Layangool³

1997

Pediatr Cardiol

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Between January 1989 and February 1995 a group of 47 consecutive infants aged 31-180 days (mean 83.5 +/- 48.8 days) with various cyanotic heart diseases and poor intracardiac mixing underwent balloon atrial septostomy (BAS) under two-dimensional (2D) echocardiographic control in the procedure room or intensive care unit. Diagnoses were 27 cases of transposition of the great arteries (TGA), 1 mitral atresia, 9 tricuspid atresia, 7 critical pulmonary stenosis with hypoplastic right ventricle, 3 pulmonary atresia with intact interventricular septum, and 1 total anomalous pulmonary venous return. A standard subcostal view was used mainly to delineate the interatrial septum and to guide the balloon catheter. The creating (tearing) of the atrial septal defect was seen clearly during the procedure, and the 2D echocardiographic imaging was helpful for assessing the adequacy of the BAS at the end of the procedure. The results were good (5-9 mm in diameter) with no significant complications. The 2D echocardiographic scans showed no significant changes in the created atrial hole sizes during the follow-up of 1-6 months. We conclude that BAS under 2D echocardiographic control can be performed successfully and safely in infants with cyanotic congenital heart disease up to 6 months of age. This method should be considered for palliation, avoidance of surgery, or allowing the patient to survive until an appropriate time for corrective surgery.

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Balloon and blade atrial septostomy facilitated by two-dimensional echocardiography

Cited by 27 publications

References 7 publications

Pediatric Therapeutic Cardiac Catheterization

Pediatric Therapeutic Cardiac Catheterization

Congenital heart disease in the newborn requiring early intervention

Balloon Atrial Septostomy Under Two-Dimensional Echocardiographic Control: A New Outlook

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