[Echocardiographic monitoring of balloon atrial septostomy].

Objective: To assess balloon atrial septostomy monitored with echocardiography.

Methods: From August 1997 to January 2004, 31 infants with congenital heart diseases indicated for balloon atrial septostomy underwent the procedure with exclusive echocardiographic monitoring. Success was defined as the obtainment of an atrial septal defect diameter > 4 mm and ample mobility of its margins.

Results: The male sex predominated (83.9%). The median age was 5 days (1-150), and the median weight was 3,300 g (1,800-7,500). Transposition of the great arteries occurred in 80.6% of the patients, tricuspid valve atresia in 12.9%, total anomalous pulmonary venous drainage in 3.2%, and pulmonary atresia with intact septum in 3.2%. The procedure was successful in all patients. The size of the atrial septal defect increased from 1.8 +/- 0.8 mm to 5.8 +/- 1.3 mm (P < 0.0001) and oxygen arterial saturation from 64.5 +/- 18.9% to 85.1 +/- 9.2% (P < 0.0001). The following complications occurred: 3 balloon ruptures, one lesion of the right femoral vein, one supraventricular tachycardia, and one atrial flutter.

Conclusion: Balloon atrial septostomy monitored with echocardiography is a safe and effective procedure. It may be performed at bedside, avoiding transporting of the patient, identifies the catheter location, reduces the occurrence of severe complications, and assesses the immediate result of the procedure.