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

J Perinatol. 2011 Jul;31(7):494-9. doi: 10.1038/jp.2010.196. Epub 2011 Jan 27.


Objective: To examine the impact of balloon atrial septostomy (BAS) on cardio-respiratory status, need for prostaglandin E(1) (PGE(1)) and postoperative outcomes in infants with transposition of great arteries (TGA).

Study design: Single-center retrospective review of consecutive neonates with dTGA.

Result: BAS was performed in 42 (70%) infants and resulted in a significant increase in minimum (61 to 76%) and maximum (80 to 90%) oxygen (O(2)) saturations and a drop in FiO(2). BAS was 'successful,' that is, PGE(1) was discontinued in 16 (38%) infants. Three infants died; four infants developed strokes, all of whom had undergone BAS. The duration of hospitalization, ventilation and O(2) need did not differ between infants without BAS, 'successful' BAS and unsuccessful BAS. PGE(1) duration correlated with duration of hospitalization, ventilation, O(2) need and peak respiratory severity score (P<0.03).

Conclusion: We speculate that limiting BAS for clinical hypoxemia and aggressive weaning of PGE(1) following BAS would improve outcomes.

Publication types

  • Comparative Study

MeSH terms

  • Atrial Septum*
  • Cardiac Catheterization / methods
  • Catheterization / methods*
  • Catheterization / mortality
  • Cohort Studies
  • Echocardiography, Doppler
  • Female
  • Follow-Up Studies
  • Hospital Mortality / trends
  • Hospitals, Pediatric
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Length of Stay
  • Male
  • Oxygen Inhalation Therapy / methods
  • Respiration, Artificial
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Transposition of Great Vessels / diagnostic imaging
  • Transposition of Great Vessels / mortality
  • Transposition of Great Vessels / therapy*
  • Treatment Outcome