Volume : 08, Issue : 01, January – 2021
124.EFFICACY OF BALLOON ATRIAL SEPTOSTOMY AS AN EMERGENCY PALLIATIVE PROCEDURE IN THE NEONATES WITH CONGENITAL CYANOTIC HEART DEFECTS
Dr Hina Lodhi, Dr Asad ur Rehman, Dr Tayyaba Roshni
Objective: Balloon atrial septostomy (BAS) is a life-saving emergency palliative procedure in the neonatal period. Data from developing countries is limited. We describe our experience with BAS over the last three years.
Methods: This study was held in the Pediatric Cardiac surgery department of Nishtar Hospital, Multan for three years duration from December 2017 to December 2020. 158 patients underwent BAS. We analyzed their procedural and postoperative data, excluding patients with accompanying problems, e.g., sepsis, birth asphyxia, prematurity.
Results: 158 patients underwent BAS. 142 were male and 16 females. The mean age was 20 days (range 1-105 days). The average weight was 3 kg (range 2.1 – 5.5 kg). The cutaneous saturation before the procedure was 59% (30-80%) and it increased to 80% (80-90%) after the procedure. 88 patients had received prostaglandin infusion prior to surgery. All of them were subsequently successfully weaned from prostaglandins. The procedure was completely echocardiographically controlled in 8 patients. In the rest, both fluoroscopy and echo were used. In 149 patients, the procedure lasted less than half an hour. In 9 patients, the procedure was technically difficult and lasted over half an hour. There was one mortality directly related to the procedure. The mean hospital stay was 48 hours after the procedure. Transient arrhythmias (supraventricular tachycardia, bradycardia) occurred in 7 patients. Three patients had transient apnea. No patient experienced balloon deflation failure.
Conclusion: A BAS can be conducted safely and effectively. It is an integral part of the management of conditions such as intact septal pulmonary atresia, TAPVC, TGA with intact septum, where atrial septum is restrictive. In these patients, BAS should be performed as the first step in treatment.
Keywords: Balloon atrial septum, Transposition of great arteries with an intact ventricular septum. Atrial septum.
Cite This Article:
Please cite this article in press Hina Lodhi et al, Efficacy Of Balloon Atrial Septostomy As An Emergency Palliative Procedure In The Neonates With Congenital Cyanotic Heart Defects., Indo Am. J. P. Sci, 2021; 08(1).
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