[2-dimensional and Doppler echocardiography during atrioseptostomy using the Rashkind method. Alternative umbilical...

Balloon atrial septostomy was performed in 16 patients using 2-D echocardiography (20 D Echo). Patients, 8 hours to 27 days old (5.6 +/- 8.5 days) had cyanotic congenital heart disease: (13 transposition of the great arteries (TGA), 2 pulmonary atresia (AP) and one mitral atresia (AM). In seven patients procedure was performed by way of saphenous-femoral vein. In the nine remaining it was done through umbilical vein, being successful in seven patients (it was necessary to use the saphenous-femoral vein in two). Seven in whom it was possible to use umbilical vein were less than 24 hours old. No complications arose as a consequence of technique, although in one, dissection performed by saphenous vein damaged femoral artery. AS was considered effective in all cases. There was no difference between results obtained by umbilical or saphenous-femoral veins. Umbilical approach proved to be simplest, fastest, and more reliable than saphenous-femoral access in the AS of those patients under 24 hours of age. Special importance is given to the value of 2-D Echo in performing AS and the immediate evaluation of the results and functional evaluation by pulsed Doppler echocardiography.