Related Experiment Video
Updated: Jul 11, 2025
07:41
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
3.7K
Balloon Atrial Septostomy: Does the Balloon Size Matter?
Jawad Al-Kassmy1,2, Iñaki Navarro-Castellanos2, Francisco Gonzalez Barlatay3
1Royal College of Surgeons in Ireland, School of Medicine, Dublin, Ireland.
CJC Pediatric and Congenital Heart Disease
|November 16, 2023
Summary
Balloon atrial septostomy (BAS) effectively treats dextro-transposition of the great arteries by improving oxygen saturation and atrial septal defect size. This study found no significant difference in outcomes between small and large BAS balloons, suggesting smaller balloons may be sufficient.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Interventional Cardiology
Background:
- Dextro-transposition of the great arteries (dTGA) is a critical congenital heart defect.
- Balloon atrial septostomy (BAS) is a life-saving procedure to improve hemodynamics in neonates with dTGA.
- Recent market changes necessitated evaluating different BAS catheter sizes.
Purpose of the Study:
- To compare the impact of two different Miller and Fogarty balloon sizes (4.0 cc vs. 1.8 cc) during BAS.
- To assess the effect of balloon size on systemic oxygen saturation and atrial septal defect (ASD) size.
- To evaluate procedure-related complications associated with different BAS balloon sizes.
Main Methods:
- Retrospective study of 134 pediatric patients with dTGA undergoing BAS between 2002 and 2018.
- Analysis of systemic oxygen saturation and resulting ASD size post-procedure.
- Comparison of complication rates between different balloon sizes.
Main Results:
- BAS significantly increased systemic oxygen saturation by 18.91% (P < 0.0001) and ASD size by 3.92 mm (P < 0.0001).
- No significant difference in oxygen saturation or final ASD size was observed between the 4.0 cc and 1.8 cc balloon groups.
- Severe or life-threatening complications were rare (1%) with no mortality.
Conclusions:
- The smaller 1.8 cc balloon is as effective as the larger 4.0 cc balloon for BAS in dTGA patients, including premature infants.
- This finding challenges the necessity of using larger balloons, potentially simplifying procedural choices.
- The study suggests that smaller BAS balloons are a viable and safe option.
