Wire Atrial Septostomy: A New Technique to Create a Large Defect in a Thickened Atrial Septum

2017 ◽  
Vol 11 (4) ◽  
pp. NP18-NP21
Author(s):  
Masataka Kitano ◽  
Masanori Tsukada ◽  
Mistuhiro Fujino
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Balloon Dilation ◽  
Atrial Septum ◽  
New Technique ◽  
Alternative Treatments ◽  
Large Defect ◽  
Balloon Atrial Septostomy ◽  
Atrial Septostomy ◽  
A New Technique

Both balloon atrial septostomy and static balloon dilation are often ineffective in creating a large atrial septal defect in patients with a thickened atrial septum. In such situations, blade atrial septostomy and atrial septal stenting are alternative treatments. We have devised and performed a new technique, called wire atrial septostomy, which uses a thin soft wire to create a large defect. The details of the procedure are presented.

scholarly journals A NEW TECHNIQUE FOR THE CREATION OF AN ATRIAL SEPTAL DEFECT WITH CLINICAL APPLICATION

1963 ◽  
Vol 46 (4) ◽  
pp. 510-521 ◽  
Author(s):  
Samuel R. Schuster ◽  
Earl Kiernan ◽  
Jens Rosencranz ◽  
Achmed Bozer
Keyword(s):  
Atrial Septal Defect ◽  
Clinical Application ◽  
Septal Defect ◽  
New Technique ◽  
The Creation ◽  
A New Technique

A New Technique for Production of Chronic Atrial Septal Defect in Cat without Thoracotomy

1979 ◽  
Vol 161 (4) ◽  
pp. 515-518
Author(s):  
G. Natarajan ◽  
R. A. Carey ◽  
R. L. Coulson ◽  
A. A. Bove ◽  
J. F. Spann
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
New Technique ◽  
A New Technique

Static balloon atrial septostomy for the purpose of left heart intervention in postoperative adult CHD

2018 ◽  
Vol 28 (10) ◽  
pp. 1116-1121
Author(s):  
Takanari Fujii ◽  
Hideshi Tomita ◽  
Yoshihito Hata ◽  
Takeshi Sasaki ◽  
Dai Asada ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Pulmonary Vein ◽  
Heart Surgery ◽  
Septal Defect ◽  
Open Heart Surgery ◽  
Interatrial Septum ◽  
Left Heart ◽  
Balloon Atrial Septostomy ◽  
Atrial Septostomy ◽  
Iatrogenic Atrial Septal Defect

AbstractBackground and purposeStatic balloon atrial septostomy is a widely accepted intervention for children with CHD. Successful surgical palliation is creating increasing numbers of adult CHD patients who need subsequent left heart intervention requiring transseptal access. In these patients, the interatrial septum is usually thick and fibrotic because of a previous open heart surgery or catheter intervention, and conventional transseptal puncture may be unsuccessful. Static balloon atrial septostomy to access the left atrium may facilitate intervention via the interatrial septum in such situations. The purpose of this study was to investigate the usefulness and the safety of static balloon atrial septostomy, and the evolution of an iatrogenic atrial septal defect post procedure in adult CHD.MethodsWe retrospectively reviewed six procedures in five adults with CHD and collected demographic characteristics, details of the procedures, clinical outcome, and size changes of the iatrogenic atrial septal defect.ResultsThe mean age at the time of the procedure was 35 years. The intended primary interventions were pulmonary vein isolation, stenting for pulmonary vein obstruction, and catheter ablation for focal atrial tachycardia. All static balloon atrial septostomies were effective, and the left heart interventions were successfully achieved via transseptal sheaths. There were no major complications associated with the static balloon atrial septostomy. There were no adverse clinical outcomes related to iatrogenic atrial septal defect, and the size of the defects regressed over time in all cases.ConclusionsStatic balloon atrial septostomy can be a safe and useful technique in adult CHD patients needing left heart procedures. The thick interatrial septum found in postoperative patients may reduce the risk of persistent iatrogenic atrial septal defect.

scholarly journals Size of atrial septal defect after balloon atrial septostomy does not correlate with immediate improvement in oxygenation

2021 ◽  
Vol 4 (1) ◽  
pp. e000224
Author(s):  
Kartik Sehgal ◽  
Kunal Sehgal ◽  
Suraj Varma
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Defect Size ◽  
Ventricular Septum ◽  
Intact Ventricular Septum ◽  
Transposition Of Great Arteries ◽  
Physiological Variables ◽  
Balloon Atrial Septostomy ◽  
Atrial Septostomy ◽  
Before And After

ObjectiveTransposition of great arteries is a common cyanotic heart defect. Balloon atrial septostomy aims to improve circulatory mixing and oxygenation. Previous studies have combined infants with intact ventricular septum and those with ventricular septal defect. Additionally, the septostomy was performed much later after birth. The objectives were to ascertain any correlation between the atrial septal defect size and oxygenation, before and after septostomy, as well the change in parameters pre-post procedure.MethodsWe performed an audit of the last 10 years of clinical and echocardiographic data (2010–2020) for infants with transposition of great arteries with intact ventricular septum. A pediatric cardiologist, masked to clinical data, reviewed the images.ResultsOur study of 25 infants with transposition of great arteries with intact ventricular septum noted that the procedure was performed at a median [interquartile range (IQR)] of 3 (2, 4) hours after birth. Prostaglandin was administered to the majority of infants [20/25 (80%)]. While significant increases in partial pressure of oxygen (24±5 vs 40±6 mmHg, p<0.001) and preductal oxygen saturations (67%±18% vs 81%±11%, p=0.003) were noted, and while the atrial septal defect increased in size from 1.8±0.6 vs 4.8±0.7 mm (p<0.001), no correlation was noted between atrial septal defect size and oxygen saturations.ConclusionsIn our study of infants with transposition of great arteries and intact ventricular septum managed with balloon atrial septostomy, no correlation was noted between the atrial septal defect size and oxygen saturations. Pulmonary vascular resistance and pulmonary blood flow may be important physiological variables determining oxygenation.

Percutaneous Treatment of Congenital Defects of the Inter-atrial Septum in Adults – Recent Advances and Persistent Pitfalls

2009 ◽  
Vol 4 (1) ◽  
pp. 76
Author(s):  
James Slater ◽  
Mark Fisch ◽  
◽  
Keyword(s):  
Atrial Septal Defect ◽  
Adult Patient ◽  
Patent Foramen Ovale ◽  
Septal Defect ◽  
Percutaneous Treatment ◽  
Atrial Septum ◽  
Congenital Defects ◽  
Foramen Ovale ◽  
Anatomy And Physiology ◽  
Specific Tissue

William Harvey was the first scientist to describe the heart as consisting of separate right- and left-sided circulations. Our understanding of the heart’s anatomy and physiology has grown significantly since this landmark discovery in 1628. Today, we recognise not only the importance of these separate systems, but also the specific tissue that divides them. Our growing understanding of the inter-atrial septum has allowed us to identify defects within this structure and develop effective percutaneous devices for closure of these defects in the adult patient. This article discusses the formation of a patent foramen ovale (PFO) and atrial septal defect (ASD). In addition, we describe the medical illnesses caused by these defects and summarise the indications and risks related to percutaneous closure of these defects. We also report the most up-to-date transcatheter therapeutic options for closure of these common congenital defects in the adult patient.

Cobra head deformity of atrial septal occluder: blessing in disguise

2020 ◽  
pp. 1-2
Author(s):  
Uma Devi Karuru ◽  
Saurabh Kumar Gupta
Keyword(s):  
Atrial Septal Defect ◽  
Left Atrial ◽  
Septal Defect ◽  
Atrial Septum ◽  
Right Atrial ◽  
Septal Occluder Device ◽  
Occluder Device ◽  
The Right

Abstract It is not uncommon to have prolapse of the atrial septal occluder device despite accurate measurement of atrial septal defect and an appropriately chosen device. This is particularly a problem in cases with large atrial septal defect with absent aortic rim. Various techniques have been described for successful implantation of atrial septal occluder in such a scenario. The essence of all these techniques is to prevent prolapse of the left atrial disc through the defect while the right atrial disc is being deployed. In this brief report, we illustrate the use of cobra head deformity of the device to successfully deploy the device across the atrial septum.

scholarly journals Laceration of atrial septum during balloon sizing of atrial septal defect

2007 ◽  
Vol 8 (2) ◽  
pp. 89-90 ◽  
Author(s):  
S SIVASANKARAN ◽  
S HARIKRISHNAN ◽  
N NARAYANAN ◽  
T JAGANMOHAN
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Atrial Septum

Echocardiographically Assisted Balloon Atrial Septostomy

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 403-408
Author(s):  
Lowell W. Perry ◽  
Roger N. Ruckman ◽  
Frank M. Galioto ◽  
Stephen R. Shapiro ◽  
Barry M. Potter ◽  
...  
Keyword(s):  
Left Atrium ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Atrial Septum ◽  
Two Dimensional ◽  
Single Plane ◽  
Balloon Atrial Septostomy ◽  
Atrial Septostomy ◽  
Dimensional Echocardiography ◽  
Two Dimensional Echocardiography

Balloon atrial septostomy is an accepted method for palliation of certain types of congenital heart disease. However, malposition of the balloon may lead to cardiac perforation, avulsion of an atrioventricular valve, or laceration of the systemic or pulmonary veins. Inasmuch as single-plane fluoroscopy may not identify balloon position correctly and as biplane fluoroscopy adds significant radiation exposure, two-dimensional echocardiography has been used to assist in balloon atrial septostomy in ten infants. The catheter is advanced from the inferior vena cava to the right atrium across the foramen ovale to the left atrium with the echo transducer in the subxiphoid position. The balloon is inflated and its position within the left atrium is confirmed by echo. The catheter is withdrawn according to the technique of Rashkind. Withdrawal is halted when the balloon traverses the atrial septum. Adequate septostomy is indicated on echo by a defect at least 5 mm in diameter and by flapping of the inferior rim of the atrial septum. There were no complications using this technique and a clinically adequate septostomy was achieved in each patient. Two-dimensional echocardiography-assisted balloon atrial septostomy minimizes risk of complications and decreases exposure to ionizing radiation.

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