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

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, PGE1 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 O2 need did not differ between infants without BAS, 'successful' BAS and unsuccessful BAS. PGE1 duration correlated with duration of hospitalization, ventilation, O2 need and peak respiratory severity score (P<0.03). Conclusion: We speculate that limiting BAS for clinical hypoxemia and aggressive weaning of PGE1 following BAS would improve outcomes. Journal of Perinatology (2011) 31, 494-499; doi:10.1038/jp.2010.196; published online 27 January 2011