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(Circulation. 1969;39:I-223.)
© 1969 American Heart Association, Inc.

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Subvalvar Pulmonary Obstruction Complicating the Postoperative Course of Balloon Atrial Septostomy in Transposition of the Great Arteries

MICHAEL TYNAN M.B., B.S.¹; IAN CARR M.B.¹; GERALD GRAHAM M.D.¹; R. E. BONHAM CARTER F.R.C.P.¹

¹ From the Thoracic Unit, The Hospital for Sick Children, Great Ormond Street, London, W.C. 1, England.

The immediate results of balloon atrial septostomy performed on 41 infants with transposition of the great arteries have been presented. There were ten hospital deaths, nine of these occurring in infants with additional cardiac malformations; five of these ten infants had operations for the additional malformations. The results show that an adequate interatrial defect can be created by balloon atrial septostomy, and it is suggested that this technique is of particular value in infants under three months of age.

Increasing cyanosis following an initial improvement after septostomy was more frequently associated with subvalvar pulmonary obstruction than with inadequacy of the atrial septal defect. Catheterization of the pulmonary artery and angiocardiography are important in the diagnosis of subvalvar pulmonary obstruction.