• Lilian M Lopes, Christiane Kawano, Salvador André Bavaresco Cristóvão, Célia Toshie Nagamatsu, Luciana da Fonseca, Beatriz Helena Sanchez Furlanetto, Gláucio Furlanetto, Silva José Pedro da JP, and José Armando Mangione.
• Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP, Brasil. lilianlopes@cardiol.br
• Arq. Bras. Cardiol. 2010 Aug 1; 95 (2): 153-8.

BackgroundThe bedside two-dimensional echocardiography (2-D ECHO) has been successfully used to guide the balloon atrial septostomy, speeding up the procedure and preventing the risks of transportation to the hemodynamics laboratory.ObjectiveTo assess the results of the bedside balloon atrial septostomy in cyanotic neonates.MethodsBetween January/1997 and July/2008, 102 atrioseptostomies by balloon catheter guided by echocardiography were carried out and saturation levels, defect diameter, oxygen saturation, clinical-laboratory response and complications related to the procedure were evaluated.ResultsOf 102 cases of bedside Rashkind septostomy, 98 met the inclusion criteria, with 90 neonates in Group A (Rashkind procedure in the preoperative phase) and 8 in Group B (procedure at the postoperative phase). There was a predominance of the male sex (75%), mean age was 8.3 ± 9.3 days and the mean weight was 3,100 ± 1,100 g; the transposition of the great arteries was the most frequent congenital heart disease (n = 74). When comparing the levels of saturation pre and post-procedure (65.9 ± 19.5% and 86 ± 9.7%) and the diameter of the interatrial septal defect pre and post-procedure (2.3 ± 1.0 mm and 5.5 ± 1.3 mm) there was a statistically significant difference (p < 0.001). When comparing the levels of saturation and the diameter of the interatrial septal defect between the group of survivors vs non-survivor, there was no statistically significant difference (p > 0.05).ConclusionThe balloon atrial septostomy guided by the echocardiography reduces the risks by allowing the effective palliative procedure to be carried out promptly in cyanotic neonates, in addition to presenting lower hospital costs.

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