Atrial Septostomy without Thoracotomy: The Experience with Transcatheter Knife Atrial Septostomy

Abstract

Four infants, three with transposition of the great arteries and one with mitral atresia and single ventricle, who did not improve following balloon atrial septostomy are presented. Each patient underwent transcatheter knife atrial septostomy with resultant improvement of interatrial mixing (in the transposition patients, there was immediate improvement in two and delayed improvement in one patient) or interatrial obstruction (in the mitral atresia patient). It is suggested that knife atrial septostomy is a safe and effective technique for nonsurgical palliation of congenital heart defects to enlarge a restrictive interatrial communication if balloon atrial septostomy has not been successful.