About Balloon Atrial Septostomy
Indications: Balloon atrial septostomy (BAS) is typically performed to address severe cyanosis (bluish discoloration of the skin) and hypoxemia (low blood oxygen levels) in newborns with certain congenital heart defects, such as transposition of the great arteries (TGA). Infants with these conditions may experience respiratory distress, poor feeding, and lethargy.

Causes: The primary conditions that lead to the need for BAS are severe cyanotic heart defects, particularly those where there is inadequate mixing of oxygen-rich and oxygen-poor blood due to structural heart abnormalities, such as TGA or hypoplastic left heart syndrome.

Treatment: BAS serves as a temporary measure to enhance oxygenation and stabilize newborns with severe cyanotic heart conditions before a more permanent surgical repair is performed. By creating an opening, or atrial septal defect (ASD), the procedure helps alleviate hypoxemia and cyanosis temporarily, allowing for better blood mixing between heart chambers. BAS is not a cure but a palliative step until definitive surgical treatment is possible.

Procedure of Balloon Atrial Septostomy
Preparation: The newborn is thoroughly evaluated, and informed consent is obtained from parents or guardians. The medical team reviews the patient’s health history, conducts necessary diagnostic tests, and ensures readiness for the procedure.

Anesthesia: The patient is placed under general anesthesia to ensure comfort and prevent movement during the procedure.

Vascular Access: A flexible catheter is inserted into a blood vessel, generally the femoral vein in the groin, and navigated through the vascular system to reach the heart.

Catheter Placement: The catheter, with a deflated balloon at the tip, is guided to the atrial septum—the wall between the upper heart chambers—using fluoroscopic imaging.

Balloon Inflation: Once in the correct position, the balloon is inflated to create an opening in the atrial septum, known as an atrial septal defect (ASD), allowing improved blood mixing.

Monitoring: The medical team monitors the patient’s vital signs, oxygen levels, and heart function throughout the procedure to ensure safety.

Post-Procedural Care: After completing the BAS, the catheter and balloon are removed, and pressure is applied to the insertion site to prevent bleeding. The patient is closely observed in a cardiac care unit for any signs of complications or changes in condition following the procedure. Additional surgical procedures may be required later to address the underlying heart defect.