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Balloon Atrial Septostomy in Congenital Heart Disease in Infancy FREE

William H. Neches, MD; Charles E. Mullins, MD; Dan G. McNamara, MD
[+] Author Affiliations

Received for publication April 28, 1972; accepted Nov 24.

Reprint requests to the Department of Pediatric Cardiology, Texas Children's Hospital, 6621 Fannin, Houston 77025 (Dr. Mullins).


Am J Dis Child. 1973;125(3):371-375. doi:10.1001/archpedi.1973.04160030043008.
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Balloon atrial septostomy was performed in 88 infants during a four-year period as palliative treatment for several different types of congenital cardiac defects including transposition of the great arteries, total anomalous pulmonary venous return, pulmonary valve atresia with intact ventricular septum plus diminutive right ventricle, tricuspid atresia, mitral atresia, and several other lesions. At the present time 60 patients (68%) are alive three months to four years following balloon septostomy, 39 without a palliative surgical procedure.

Balloon septostomy without additional palliative surgery can provide effective long-term palliation in infants with some types of transposition of the great arteries or total anomalous pulmonary venous return. Most patients with the other cardiac defects listed require additional surgical palliation. Hemodynamic improvement provided by septostomy and palliative surgery is often sufficient to enable long-term survival in patients with uncorrectable defects.

REFERENCES

Rashkind WJ, Miller WW:  Creation of an atrial septal defect without thoracotomy: Palliative approach to complete transposition of the great arteries . JAMA 196:991-992, 1966;.
Rashkind WJ, Miller WW:  Transposition of the great arteries: Result of palliation by balloon atrioseptostomy in thirty-one infants . Circulation 38:453-462, 1968;.
Rashkind WJ, et al:  Management of tricuspid atresia in infancy: Use of balloon catheter atrial septostomy followed by ascending aorta to right pulmonary artery anastomosis , abstract. Circulation 35 and 36 ( (suppl 11) ):11-217, 1967;.
Seratto M, et al:  Palliative balloon atrial septostomy for total anomalous pulmonary venour connection in infancy . J Pediatr 73:734-739, 1968;.
Rowe RD, Mehrizi A: The Neonate With Congenital Heart Disease . Philadelphia, WB Saunders Co, 1968;.
Rashkind WH:  Atrioseptostomy by balloon catheter in congenital heart disease . Radiol Clin North Am 9:193-202, 1971;.
Mullins CE, Neches WH, McNamara DG:  The infant with transposition of the great arteries: I. Cardiac catheterization protocol . Am Heart J 84:597-602, 1972;.
Neches WH, Mullins CE, McNamara DG:  The infant with transposition of the great arteries: II. Results of balloon atrial septostomy . Am Heart J 84:603-609, 1972;.
Venables AW:  Balloon atrial septostomy in complete transposition of the great arteries in infancy . Br Heart J 32:61-65, 1970;.
Baker F, et al:  Effectiveness of the Rashkind procedure in transposition of the great arteries in infants . Circulation 43 and 44 ( (suppl I) ):I-1-I-6, 1971;.
Singh SP, Astley R, Burrows FGO:  Balloon septostomy for transposition of the great arteries . Br Heart J 31:722-726, 1969;.
Plauth WH Jr, et al:  Changing hemodynamics in patients with transposition of the great arteries . Circulation 42:131-142, 1969;.
Seratto M, et al:  Total anomalous pulmonary venous connection without obstruction: Hemodynamic and prognostic importance of foramen ovale size , abstract. Circulation 35 and 36 ( (suppl II) ):II-232, 1967;.
Miller WW, et al:  Total anomalous pulmonary venous return: Effective palliation of critically ill infants by balloon atrial septostomy , abstract. Circulation 35 and 36 ( (suppl II) ):II-189, 1967;.
El-Said G, Mullins CE, McNamara DG:  Management of total anomalous pulmonary venous return . Circulation 45:1240-1250, 1972;.
Behrendt DM, et al:  Total anomalous pulmonary venous drainage in infants: I. Clinical and hemodynamic findings, methods, and results of operation in 37 cases . Circulation 46:347-356, 1972;.
Miller WW, Rashkind WJ:  Palliative treatment of total anomalous pulmonary venous drainage by balloon atrial septostomy . Lancet 2:387-388, 1968;.
Shams A, et al:  Pulmonary atresia with intact ventricular septum: Report of 50 cases . Pediatrics 47:370-377, 1971;.
Trusler GA, Fowler RS:  The surgical management of pulmonary atresia with intact ventricular septum and hypoplastic right ventricle . J Thorac Cardiovasc Surg 59:740-743, 1970;.
Dhanavaravibul S, Nora JJ, McNamara DG:  Pulmonary valvular atresia with intact ventricular septum: Problems in diagnosis and results of treatment . J Pediatr 77:1010-1016, 1970;.
Bowman FO Jr, et al:  Pulmonary atresia with intact ventricular septum . J Thorac Cardiovasc Surg 61:85-95, 1971;.
Gasul BM, Arcilla RA, Lev M: Heart Disease In Children . Philadelphia, JB Lippincott Co, 1966;.
Lenox CC, Zuberbuhler JR:  Balloon septostomy in tricuspid atresia after infancy . Am J Cardiol 25:723-726, 1970;.

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References

Rashkind WJ, Miller WW:  Creation of an atrial septal defect without thoracotomy: Palliative approach to complete transposition of the great arteries . JAMA 196:991-992, 1966;.
Rashkind WJ, Miller WW:  Transposition of the great arteries: Result of palliation by balloon atrioseptostomy in thirty-one infants . Circulation 38:453-462, 1968;.
Rashkind WJ, et al:  Management of tricuspid atresia in infancy: Use of balloon catheter atrial septostomy followed by ascending aorta to right pulmonary artery anastomosis , abstract. Circulation 35 and 36 ( (suppl 11) ):11-217, 1967;.
Seratto M, et al:  Palliative balloon atrial septostomy for total anomalous pulmonary venour connection in infancy . J Pediatr 73:734-739, 1968;.
Rowe RD, Mehrizi A: The Neonate With Congenital Heart Disease . Philadelphia, WB Saunders Co, 1968;.
Rashkind WH:  Atrioseptostomy by balloon catheter in congenital heart disease . Radiol Clin North Am 9:193-202, 1971;.
Mullins CE, Neches WH, McNamara DG:  The infant with transposition of the great arteries: I. Cardiac catheterization protocol . Am Heart J 84:597-602, 1972;.
Neches WH, Mullins CE, McNamara DG:  The infant with transposition of the great arteries: II. Results of balloon atrial septostomy . Am Heart J 84:603-609, 1972;.
Venables AW:  Balloon atrial septostomy in complete transposition of the great arteries in infancy . Br Heart J 32:61-65, 1970;.
Baker F, et al:  Effectiveness of the Rashkind procedure in transposition of the great arteries in infants . Circulation 43 and 44 ( (suppl I) ):I-1-I-6, 1971;.
Singh SP, Astley R, Burrows FGO:  Balloon septostomy for transposition of the great arteries . Br Heart J 31:722-726, 1969;.
Plauth WH Jr, et al:  Changing hemodynamics in patients with transposition of the great arteries . Circulation 42:131-142, 1969;.
Seratto M, et al:  Total anomalous pulmonary venous connection without obstruction: Hemodynamic and prognostic importance of foramen ovale size , abstract. Circulation 35 and 36 ( (suppl II) ):II-232, 1967;.
Miller WW, et al:  Total anomalous pulmonary venous return: Effective palliation of critically ill infants by balloon atrial septostomy , abstract. Circulation 35 and 36 ( (suppl II) ):II-189, 1967;.
El-Said G, Mullins CE, McNamara DG:  Management of total anomalous pulmonary venous return . Circulation 45:1240-1250, 1972;.
Behrendt DM, et al:  Total anomalous pulmonary venous drainage in infants: I. Clinical and hemodynamic findings, methods, and results of operation in 37 cases . Circulation 46:347-356, 1972;.
Miller WW, Rashkind WJ:  Palliative treatment of total anomalous pulmonary venous drainage by balloon atrial septostomy . Lancet 2:387-388, 1968;.
Shams A, et al:  Pulmonary atresia with intact ventricular septum: Report of 50 cases . Pediatrics 47:370-377, 1971;.
Trusler GA, Fowler RS:  The surgical management of pulmonary atresia with intact ventricular septum and hypoplastic right ventricle . J Thorac Cardiovasc Surg 59:740-743, 1970;.
Dhanavaravibul S, Nora JJ, McNamara DG:  Pulmonary valvular atresia with intact ventricular septum: Problems in diagnosis and results of treatment . J Pediatr 77:1010-1016, 1970;.
Bowman FO Jr, et al:  Pulmonary atresia with intact ventricular septum . J Thorac Cardiovasc Surg 61:85-95, 1971;.
Gasul BM, Arcilla RA, Lev M: Heart Disease In Children . Philadelphia, JB Lippincott Co, 1966;.
Lenox CC, Zuberbuhler JR:  Balloon septostomy in tricuspid atresia after infancy . Am J Cardiol 25:723-726, 1970;.

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