Balloon atrial septostomy at Queen Sirikit National Institute of Child Health in the year 2001.
BACKGROUND
Balloon atrial septostomy (BAS) is a safe and effective palliative procedure for patients with cyanotic congenital heart disease. The first BAS in Thailand was performed in 1987 at our institute and there have been many changes since that time.


OBJECTIVE
To evaluate the immediate and intermediate outcomes of BAS in the new century.


METHODS
Thirty patients who underwent BAS from January to December 2001 were included in this study. Epidemiologic data, echocardiographic diagnosis, changing techniques from the previous report and the clinical course for patients were reviewed. The end point of follow-up for this study was December 2002.


RESULTS
Thirty patients underwent BAS from January to December 2001 with an age range from 1 to 213 days (mean 30.40 +/- 41.97 days). BAS was selectively tried via the umbilical vein in 6 cases. This was successful in 4 cases. Others were performed successfully via the femoral vein. The most common diagnoses were complete transposition of the great arteries (TGA), pulmonary atresia (PA) with intact ventricular septumand transposition of the great arteries with ventricular septal defect (TGA, VSD) respectively. No immediate complications were found in the present study. There were 5 deaths prior to surgery and 2 post-operative deaths accounting for a total mortality of 23.3 per cent.


CONCLUSIONS
BAS is a safe and effective palliative procedure for patients with various types of cyanotic congenital heart disease even in infants up to 7 months of age. The umbilical venous route can be used effectively without significant problems. Although the overall mortality is high, it is not related to BAS.
Sangtawesin
Chaisit
C
Pediatric Cardiology Unit, Queen Sirikit National Institute of Child Health, Bangkok 10400, Thailand.
Layangkool
Thanarat
T
Kirawitaya
Thawatchai
T
Petchdamrongsakul
Amornrat
A
Intasorn
Chanisa
C
Noisaeng
Puttha
P
Glundeema
Sompun
S
D002404:Catheterization / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006346:Heart Septum / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010166:Palliative Care; D016896:Treatment Outcome