Interatrial groove tear: an unusual complication of balloon atrial septostomy

The authors present an unusual complication of the balloon atrial septostomy procedure performed in a neonate with D-transposition of the great arteries. Cardiac tamponade developed shortly after the balloon atrial septostomy procedure and the infant was found to have a tear in the superior aspect of the left atrium, parallel to the interatrial groove. The tear was successfully sutured and may have been caused by the greater pull-back force needed if the catheter balloon is maximally distended for the first pull-back.