Hostname: page-component-76dd75c94c-8c549 Total loading time: 0 Render date: 2024-04-30T07:55:39.640Z Has data issue: false hasContentIssue false

Improvised bespoke technique for atrial septostomy in the shortage of atrioseptostomy balloon catheters

Published online by Cambridge University Press:  25 August 2023

Raymond N. Haddad*
Affiliation:
M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
Zainab Alawadhi
Affiliation:
Department of Pediatric Cardiology, Heart Centre of Excellence, Al Jalila Children’s Speciality Hospital, Dubai, United Arab Emirates
Mahmoud Al Soufi
Affiliation:
Department of Pediatric Cardiology, Heart Centre of Excellence, Al Jalila Children’s Speciality Hospital, Dubai, United Arab Emirates
Mohamed Kasem
Affiliation:
Department of Pediatric Cardiology, Heart Centre of Excellence, Al Jalila Children’s Speciality Hospital, Dubai, United Arab Emirates
*
Corresponding author: R. N. Haddad; Email: raymondhaddad@live.com

Abstract

Atrioseptostomy balloon catheter is an essential item to have on our shelves. However, the recall and shortage in production of the commonly used balloon atrioseptostomy catheters posed an imminent threat to our patients. Herein, we present the case of a newborn with a post-natal diagnosis of simple transposition of great arteries and restrictive atrial communication where repeated static balloon atrial septostomy using a 9 mm x 20 mm Sterling balloon failed to improve his status. We had to improvise per-operatively a new bespoke technique to perform a vital pull-through balloon atrial septostomy. The distal third of a 10 mm x 20 mm semi-compliant Cristal balloon was exteriorised out the tip of a 6-Fr 55 cm Cook Flexor sheath in the left atrium, and both were simultaneously pulled back to the right atrium to create an 8 mm septal defect. The procedure was successful without any complications. The baby was weaned off prostaglandin on day 3 and surgically repaired on day 5 with excellent results.

Type
Brief Report
Copyright
© The Author(s), 2023. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rashkind, WJ, Miller, WW. Creation of an atrial septal defect without thoracotomy. a palliative approach to complete transposition of the great arteries. JAMA 1966; 196: 991992.CrossRefGoogle ScholarPubMed
Cinteza, E, Carminati, M. Balloon atrial septostomy - almost half a century after. Maedica (Bucur) 2013; 8: 280284.Google ScholarPubMed
Hijazi, ZM, Abu Ata, I, Kuhn, MA, Cheatham, JP, Latson, L, Geggel, RL. Balloon atrial septostomy using a new low-profile balloon catheter: initial clinical results. Cathet Cardiovasc Diagn 1997; 40: 187190. DOI: 10.1002/(sici)1097-0304(199702)40.3.0.CO;2-O>CrossRefGoogle ScholarPubMed
Baba, K, Suda, K, Takamuro, M, et al. Static balloon atrial septostomy in Japan in shortage of standard balloon septostomy catheter. J Cardiol 2021; 78: 219223. DOI: 10.1016/j.jjcc.2021.04.008.CrossRefGoogle ScholarPubMed
Inuzuka, R, Tachimori, H, Kim, SH, et al. Practice and safety of static balloon atrial septostomy based on a nationwide registry data. Circ J 2022; 86: 19901997. DOI: 10.1253/circj.CJ-22-0185.CrossRefGoogle ScholarPubMed
Sugiyama, H, Fujimoto, K, Ishii, T, Nakanishi, T, Tomita, H. Impact of novel balloon catheter on static balloon atrial septostomy with double balloon technique in infants with congenital heart disease. Circ J 2015; 79: 23672371. DOI: 10.1253/circj.CJ-15-0480.CrossRefGoogle ScholarPubMed
Korns, ME, Garabedian, HA, Lauer, RM. Anatomic limitations of balloon atrial septostomy. Hum Pathol 1972; 3: 345349. DOI: 10.1016/s0046-8177(72)80035-2.CrossRefGoogle ScholarPubMed
Mukherjee, D, Lindsay, M, Zhang, Y, et al. Analysis of 8681 neonates with transposition of the great arteries: outcomes with and without Rashkind balloon atrial septostomy. Cardiol Young 2010; 20: 373380. DOI: 10.1017/S1047951110000296.CrossRefGoogle ScholarPubMed
Supplementary material: File

Haddad et al. supplementary material 1
Download undefined(File)
File 13.1 MB
Supplementary material: File

Haddad et al. supplementary material 2
Download undefined(File)
File 862.6 KB
Supplementary material: File

Haddad et al. supplementary material 3
Download undefined(File)
File 23.5 MB