Stenting of a restrictive foramen ovale in a patient with hypoplastic left heart syndrome

Single Ventricle—A Comprehensive Review

“…When PFO obstruction develops during the later part of the neonatal period or in older infants, balloon atrial septostomy is unlikely to be successful, and in such situations, alternative methods such as blade atrial septostomy [ 53 ], static balloon dilatation [ 54 , 55 ], or stent placement [ 56 , 57 , 58 ] may have to be used to accomplish the relief of inter-atrial obstruction. If transcatheter methods are not feasible or not successful, surgical atrial septectomy is necessary.…”

“…If there is no PFO and the atrial septum is intact, the atrial septum may be perforated either by Brockenbrough technique [ 59 ] or radiofrequency perforation [ 60 ]. This should be followed by static dilatation [ 54 , 55 ] or stent placement across the atrial septum [ 56 , 57 , 58 ]. For a detailed discussion of these transcatheter techniques, the interested reader may review the author’s previous publications [ 58 , 61 ].…”

“…Rashkind septostomy may not be feasible in some patients either because of thick atrial septal tissue and/or small left atria. In such situations, atrial septal restriction may be relieved by static balloon dilatation [ 54 , 55 ] ( Figure 18 ) or stent implantation [ 55 , 56 , 57 , 58 , 61 , 89 ] ( Figure 19 and Figure 20 ). If transcatheter methods are not feasible or not successful, surgical septostomy becomes necessary.…”

Transposition of the Great Arteries

“…7 A built-in retractable blade (knife) cuts the lower margin of the patent foramen ovale (PFO) which is followed by balloon atrial septostomy. More recently, static balloon angioplasty, 6,8,9 stents, [10][11][12] Brockenbrough atrial septal puncture, 12 radiofrequency ablation [13][14][15] and cutting balloons were applied to create and/or enlarge the atrial defects 4 . In most patients conventional balloon atrial septostomy is all that is necessary to palliate TGA patients until surgery.…”