Balloon atrial septostomy through azygos vein in two cases of D-TGA with left atrial isomerism

2021 ◽  
pp. 1-2
Author(s):  
Meryem Beyazal ◽  
Utku Arman Orun
Keyword(s):  
Septal Defect ◽  
Azygos Vein ◽  
Important Condition ◽  
Transposition Of Great Arteries ◽  
Balloon Atrial Septostomy ◽  
Palliative Procedure ◽  
Left Isomerism ◽  
Atrial Septostomy ◽  
Cardiac Surgeon ◽  
Atrial Isomerism

Abstract Balloon atrial septostomy is a palliative procedure that is performed in D-transposition of great arteries when surgery is not immediately available. Although D-TGA and left isomerism association are rare, it is an important condition as the BAS procedure approach is unique. In this case report, we present two cases of D-TGA with left isomerism where BAS was performed due to restrictive atrial septal defect and lack of immediate availability of the paediatric cardiac surgeon.

scholarly journals Size of atrial septal defect after balloon atrial septostomy does not correlate with immediate improvement in oxygenation

2021 ◽  
Vol 4 (1) ◽  
pp. e000224
Author(s):  
Kartik Sehgal ◽  
Kunal Sehgal ◽  
Suraj Varma
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Defect Size ◽  
Ventricular Septum ◽  
Intact Ventricular Septum ◽  
Transposition Of Great Arteries ◽  
Physiological Variables ◽  
Balloon Atrial Septostomy ◽  
Atrial Septostomy ◽  
Before And After

ObjectiveTransposition of great arteries is a common cyanotic heart defect. Balloon atrial septostomy aims to improve circulatory mixing and oxygenation. Previous studies have combined infants with intact ventricular septum and those with ventricular septal defect. Additionally, the septostomy was performed much later after birth. The objectives were to ascertain any correlation between the atrial septal defect size and oxygenation, before and after septostomy, as well the change in parameters pre-post procedure.MethodsWe performed an audit of the last 10 years of clinical and echocardiographic data (2010–2020) for infants with transposition of great arteries with intact ventricular septum. A pediatric cardiologist, masked to clinical data, reviewed the images.ResultsOur study of 25 infants with transposition of great arteries with intact ventricular septum noted that the procedure was performed at a median [interquartile range (IQR)] of 3 (2, 4) hours after birth. Prostaglandin was administered to the majority of infants [20/25 (80%)]. While significant increases in partial pressure of oxygen (24±5 vs 40±6 mmHg, p<0.001) and preductal oxygen saturations (67%±18% vs 81%±11%, p=0.003) were noted, and while the atrial septal defect increased in size from 1.8±0.6 vs 4.8±0.7 mm (p<0.001), no correlation was noted between atrial septal defect size and oxygen saturations.ConclusionsIn our study of infants with transposition of great arteries and intact ventricular septum managed with balloon atrial septostomy, no correlation was noted between the atrial septal defect size and oxygen saturations. Pulmonary vascular resistance and pulmonary blood flow may be important physiological variables determining oxygenation.

scholarly journals Survival after balloon atrial septostomy for complete transposition of great arteries.

1987 ◽  
Vol 62 (6) ◽  
pp. 549-553 ◽  
Author(s):  
Q Mok ◽  
F Darvell ◽  
S Mattos ◽  
T Smith ◽  
P Fayers ◽  
...  
Keyword(s):  
Transposition Of Great Arteries ◽  
Balloon Atrial Septostomy ◽  
Complete Transposition ◽  
Atrial Septostomy

scholarly journals Impact of balloon atrial septostomy in neonates with transposition of great arteries

2011 ◽  
Vol 31 (7) ◽  
pp. 494-499 ◽  
Author(s):  
G Hiremath ◽  
G Natarajan ◽  
D Math ◽  
S Aggarwal
Keyword(s):  
Transposition Of Great Arteries ◽  
Balloon Atrial Septostomy ◽  
Atrial Septostomy

scholarly journals Balloon atrial septostomy as initial therapy in pediatric pulmonary hypertension

2020 ◽  
Vol 10 (4) ◽  
pp. 204589402095897
Author(s):  
Paul J. Critser ◽  
Patrick D. Evers ◽  
Eimear McGovern ◽  
Michelle Cash ◽  
Russel Hirsch
Keyword(s):  
Pulmonary Hypertension ◽  
High Risk ◽  
Lung Transplantation ◽  
Initial Therapy ◽  
Free Survival ◽  
Balloon Atrial Septostomy ◽  
Single Center Experience ◽  
Palliative Procedure ◽  
Atrial Septostomy ◽  
Procedural Complications

Balloon atrial septostomy is a palliative procedure currently used to bridge medically refractory pulmonary hypertension patients to lung transplantation. In the current report, we present balloon atrial septostomy as an initial therapy for high-risk pediatric pulmonary hypertension patients at our institution. Nineteen patients with median age of 4.3 years (range 0.1–14.3 years) underwent balloon atrial septostomy during initial admission for pulmonary hypertension. There were no procedural complications or deaths within 24 h of balloon atrial septostomy. Patients were followed for a median of 2.6 years (interquartile range 1.0–4.8 years). Three (16%) patients died, 3 (16%) underwent lung transplantation, and 1 (5%) underwent reverse Potts shunt. Transplant-free survival at 30 days, 1 year, and 3 years was 84%, 76%, and 67% respectively. This single-center experience suggests early-BAS in addition to pharmacotherapy is safe and warrants consideration in high-risk pediatric pulmonary hypertension patients.

Balloon atrial septostomy in the intensive care unit under echocardiographic control—nine years experience

1992 ◽  
Vol 2 (2) ◽  
pp. 175-178 ◽  
Author(s):  
Ashok P. Kakadekar ◽  
Alison Hayes ◽  
Eric Rosenthal ◽  
Ian C. Huggon ◽  
Edward J. Baker ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Femoral Vein ◽  
Left Ventricular ◽  
Balloon Atrial Septostomy ◽  
Associated Lesions ◽  
Atrial Septostomy ◽  
The Mean

SummaryBetween December 1982 and April 1991, balloon atrial septostomy was performed in the intensive care unit under echocardiographic control in 60 neonates. Of the patients, 58 had complete transposition. Two patients had double outlet right ventricle with a sub-pulmonary ventricular septal defect. Associated lesions included a patent arterial duct in 19 patients, ventricular septal defect in nine, obstruction of the left ventricular outflow tract in six, aortic coarctation in two and tricuspid atresia in one. The mean age at septostomy was four days (range 4 hours - 25 days) and the mean weight 3.19 kg (range 1.17–4.25 kg). In 39 (65%) patients, an infusion of prostaglandin was in progress prior to the septostomy and 22 (37%) were being ventilated. Standard subcostal four-chamber echocardiographic views were used to show the atrial septum and to guide the catheter used for septostomy. Venous access was obtained via the femoral vein in 43 (by percutaneous puncture in 40 and by cutdown in three) and the umbilical vein in 17. Transient atrial arrhythmias were common during the septostomy but no acute hemodynamic disturbances or deaths occurred during the procedure. The size of the atrial septal defect as measured by echocardiography after the septostomy ranged from three to 12 mm in diameter. In only one patient was this inadequate. Three (5%) patients died between two and 10 days after the septostomy, two due to necrotizing enterocolitis and one from persistent hypoxemia. One patient had a cerebral thrombosis and convulsions immediately after the septostomy but made a good neurological recovery. Corrective surgery was performed in 52 (86.6%), two (3.3%) had palliative surgery and two were considered unsuitable for total correction, of whom one has died. One patient died whilst awaiting correction. We conclude that balloon atrial septostomy using echocardiographic guidance can be safely and effectively performed in the intensive care unit.

Prevalence and Outcomes of Balloon Atrial Septostomy in Neonates With Transposition of Great Arteries

2020 ◽  
Vol 21 (4) ◽  
pp. 324-331 ◽  
Author(s):  
Mohammed Hamzah ◽  
Hasan F. Othman ◽  
Allison M. Peluso ◽  
Ibrahim Sammour ◽  
Hany Aly
Keyword(s):  
Transposition Of Great Arteries ◽  
Balloon Atrial Septostomy ◽  
Atrial Septostomy

Wire Atrial Septostomy: A New Technique to Create a Large Defect in a Thickened Atrial Septum

2017 ◽  
Vol 11 (4) ◽  
pp. NP18-NP21
Author(s):  
Masataka Kitano ◽  
Masanori Tsukada ◽  
Mistuhiro Fujino
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Balloon Dilation ◽  
Atrial Septum ◽  
New Technique ◽  
Alternative Treatments ◽  
Large Defect ◽  
Balloon Atrial Septostomy ◽  
Atrial Septostomy ◽  
A New Technique

Both balloon atrial septostomy and static balloon dilation are often ineffective in creating a large atrial septal defect in patients with a thickened atrial septum. In such situations, blade atrial septostomy and atrial septal stenting are alternative treatments. We have devised and performed a new technique, called wire atrial septostomy, which uses a thin soft wire to create a large defect. The details of the procedure are presented.

scholarly journals Factors influencing survival after balloon atrial septostomy for complete transposition of great arteries.

Heart ◽  
1981 ◽  
Vol 45 (5) ◽  
pp. 559-572 ◽  
Author(s):  
R Leanage ◽  
A Agnetti ◽  
G Graham ◽  
J Taylor ◽  
F J Macartney
Keyword(s):  
Transposition Of Great Arteries ◽  
Balloon Atrial Septostomy ◽  
Complete Transposition ◽  
Factors Influencing ◽  
Atrial Septostomy
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