A simple surgical atrial septectomy for complex congenital heart disease

A simple method of surgical atrial septectomy using a rongeur (Kerrison bone-cutting forceps), which is used in neurosurgery, is described. The closed rongeur is inserted into the left atrium through the right atrial appendage and the atrial septum. Then it is opened and the edge of the atrial septal defect and/or patent foramen ovale can be hooked by pulling slowly. The rongeur is then tightly closed again and pulled out together with the resected atrial specimen. This technique is safer and simpler than the Blalock-Hanlon technique or atrial septectomy with extra-corporeal circulation for older infants in whom balloon atrial septostomy is difficult.