All issues > Volume 34(9); 1991

Original Article

J Korean Pediatr Soc. 1991;34(9):1294-1298. Published online September 30, 1991.

Balloon atrial septostomy through umbilical vein approach using flexible guide wire and sheath technique.

In Sook Park¹, Ki Soo Kim¹, Chang Yee Hong¹, Shi Joon Yoo²

¹Department of Pediatrics, College of Medicine, Ulsan Uiversity and Asan Medical Center
²Department of Diagnostic Radiology, College of Medicine, Ulsan Uiversity and Asan Medical Center

Received: March 29, 1991;  Accepted: June 3, 1991.

Abstract

Balloon atrial septostomy is accepted as the best initial palliative treatment in infants with certain types of cyanotic congenital heart disease and the importance of prompt creation of atrial communi- cation can not be overemphasized in these patients. Balloon atrial septostomy is performed through femoral vein using percutaneous technique in most cases and is rarely done by cut down approach. However, percutaneous femoral vein cannulation or saphenous vein cut down can be time consuming and sometimes impossible in critically ill neonates or in neonates with deformities of the lower extremities or anomalies of the inferior vena cava. In these situations, cardiac catheterization and balloon atrial septostomy can be performed much quickly through umbilical vein approach. This report describes the results of balloon atrial septos- tomy performed through umbilical vein in two neonates at Asan Medical Center. Furthermore, when ductus venosus is restrictive, specially designed soft, flexible, J-tip guide wire and sheath can be used to help advancing diagnostic and septostomy catheters from the umbilical vein into the cardiac chambers and this technique was used in one patient with congenital bilateral hip dislocation.

Keywords :Ballon atrial septostomy;Umbilical vein;Congenital heart disease