Abstract
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 6 years. Methods: From January 2006 to September 2012, 158 patients underwent BAS. We reviewed their procedural and post-procedural data, excluding any patient having concomitant problems, e.g. sepsis, birth asphyxia, prematurity. Results: 158 patients underwent BAS from January 2006 to September 2012. 142 were male and 16 were female. Mean age was 20 days (range 1-105 days). Mean weight was 3 kg( range 2.1 - 5.5 kg). Pre-procedural cutaneous saturation was 59% (30-80%) increasing to 80% (80-90%) postprocedure. 88 patients were on prostaglandin infusion before the procedure. All were successfully off prostaglandin afterwards. The procedure was totally echo guided in 8 patients. Both fluoroscopy and echo were used in the rest. In 149 patients the procedure took less than half an hour. In 9 patients the procedure was technically difficult and took more than half an hour. There was one mortality directly related to the procedure. The mean duration of hospital stay was 48 hr postprocedure. Transient arrhythmias (supreaventricular tachycardia, bradycardia) occurred in 7 patients. 3 patients had transient apnea. We did not encounter balloon deflation failure in any patient. Conclusion: BAS can be undertaken safely and effectively. It is an integral part of management of conditions like pulmonary atresia with intact septum, TAPVC, TGA with intact septum where interatrial septum is restrictive. In these patients BAS should be performed as first step of treatment
