If a baby is born with a heart defect, they may need an atrial septostomy. The primary goal of an atrial septostomy is to improve blood flow or relieve pressure in one side of the heart.
Atrial septostomy is a procedure that creates a small hole between the two upper chambers of the heart (the atria). This hole helps to balance blood pressure in the heart or improve how much oxygen gets into the blood. It's often done quickly after birth in urgent situations. It's important to remember that this procedure doesn't fix the underlying problem, but it does help manage the symptoms.
The procedure is most commonly performed in infants with specific types of severe congenital heart disease where blood flow or pressure dynamics are critically imbalanced:
If your child needs an atrial septostomy, you want care from a team dedicated to excellent care, compassion, and a multidisciplinary approach. That’s what you’ll experience at AHN. Our specialists have extensive experience in congenital heart defects and successful procedure outcomes. You’ll be met with providers who communicate complex medical information clearly and empathetically, while actively listening to any concerns you may have to foster a trusting, transparent relationship that you can depend upon.
An atrial septostomy, a vital heart procedure primarily for infants with specific congenital heart defects, is performed exclusively in a hospital's cardiac catheterization lab.
Preparation involves thorough medical evaluations and discussions with specialists to understand the procedure and anesthesia. During the procedure, the patient receives general anesthesia, and a thin catheter is guided through a vein (usually in the groin) to the heart. A balloon on the catheter is then inflated to create or enlarge an opening between the heart's upper chambers, improving blood mixing. The actual procedure typically takes 30 minutes to an hour, followed by monitoring in a recovery unit and a hospital stay ranging from a few days to longer, depending on the patient's condition.
Recovery will depend on the individual and can vary based on their personal health. After the procedure, the patient will be moved to a recovery area or an intensive care unit (ICU) for close monitoring. In recovery heart rate, breathing, blood pressure, and oxygen levels will be continuously monitored. The insertion site will also be checked for bleeding. The patient will need to lie still for several hours to allow the insertion site to heal and prevent bleeding.
Once the patient is more stable, feeding will be gradually reintroduced. The length of stay in the hospital can vary. For a straightforward procedure, it might be a few days, but it could be longer if the patient is very ill or requires additional monitoring and support.
Regular follow-up appointments with the cardiologist will be necessary to monitor the heart's function and the effects of the septostomy.
Questions about atrial septostomy are normal and expected. Navigating a heart condition can be an overwhelming experience, and AHN is here to help. These frequently asked questions can provide a good starting point to conversations with your care team and may help provide some much-needed information as you determine your care options.
An atrial septostomy works by creating or enlarging an opening between the two upper chambers of the heart, the atria. This is typically done using a cardiac catheter, a thin tube inserted into a blood vessel (usually in the groin) and guided to the heart. Once in place, a balloon at the tip of the catheter is inflated across the atrial septum (the wall separating the atria), tearing or stretching it to allow more blood to mix between the left and right sides of the heart, improving oxygen saturation.
The primary purpose of an atrial septostomy is to improve blood mixing between the systemic and pulmonary circulations in infants and children with certain complex congenital heart defects, most notably D-transposition of the great arteries (d-TGA). In these conditions, the heart's natural pathways prevent proper oxygenation of the blood, and creating a larger atrial opening allows oxygen-rich and oxygen-poor blood to mix, ensuring more oxygenated blood reaches the body's organs and tissues, which is crucial for survival until definitive repair surgery can be performed.
Another common name for a balloon atrial septostomy is Rashkind procedure or Rashkind balloon septostomy, named after Dr. William Rashkind, who developed the technique.
An atrial septostomy is needed when there is insufficient mixing of oxygenated and deoxygenated blood in the heart due to a congenital heart defect, leading to dangerously low oxygen levels in the body. For example, in transposition of the great arteries, the two main arteries leaving the heart are switched, so the body doesn't receive enough oxygen. Creating or enlarging the opening between the atria allows more blood to mix, temporarily improving oxygen delivery to the body and stabilizing the patient until more definitive corrective surgery can be safely performed.
Call (412) DOCTORS 412-362-8677 or request an appointment with AHN cardiovascular services.
