Balloon septostomy
Balloon septostomy is a laparoscopic heart technique utilized to invent/create a vent in the atrial septum (the wall in middle of the heart’s upper chamber). Balloon septostomy is also famous for balloon atrial septostomy or Rashkind procedure.
This procedure is done by using balloon tipped catheter for better oxygen supply and blood flow in neonates with congenital heart defects.
Balloon septostomy requires only local anesthesia by fluoroscopy or echocardiography to set catheter placement and balloon inflation properly.
Balloon septostomy is a somewhat effective and secure method as compared to others. This procedure is substantially better technique for neonates in the requirement of oxygen saturation, also increasing the survival chance after postnatal period.
Types of Balloon septostomy
There are two types of Balloon septostomy.
- This procedure is used as a temporary fix for neonates which have congenital defects. Rashkind Balloon septostomy accomplished during cardiac catheterization. In the naturally placed hole in the upper chamber of heart the compressed balloon through a blood vessel is inserted and creates a large opening for mixing of oxygenated and deoxygenated blood.
- In this method surgical opening creates a hole in the atrial septum for mixing of blood. This technique is rare and requires surgical open heart surgery.
Complication of Balloon Septostomy
Some of the complications developed after balloon septostomy which are as:
- Thrombus formation or stroke
- Sinus bradycardia
- Bleeding
- Heart rhythm disturbances or arrhythmias
- Infection
- Mitral or tricuspid valve tear
- Reduced perfusion to lower limbs
- Cardiac tamponade
- Rupture of inferior vena cava (IVC)
- Hemopericardium or perforation of the heart
- Rupture of the balloon
- Pulmonary vein avulsion
Diagnostic Tests
Physical Examination
The doctors examine the patients by seeing the bluish skin, heart murmurs which is the indication.
- Chest X-ray Enlarged heart or other abnormalities found by X-ray.
- Pulse Oximetry Oxygen saturation of the blood measures by Pulse Oximetry.
- Electrocardiogram (ECG) Abnormal heart rhythms determined by ECG.
- Echocardiogram The action of the valve, blood flow and cardiac anatomy images will be found by Echocardiogram.
- Cardiac Catheterization The catheter will be inserted into blood vessels to find out pressure and calculate cardiac blood flow.
Advantages of Balloon Septostomy
Advantages of Balloon Septostomy in India, including neonates with restrictive interatrial communication, cyanotic congenital heart defects and it helps in stabilizing pulmonary vascular resistance.
Some of the lead advantages are as follows.
- Balloon Septostomy will improve oxygenation by creating the connection between the atria, resulting in better systematic oxygen.
- Balloon Septostomy may stabilize pulmonary vascular resistance.
- In Balloon Septostomy procedures that provide flexibility in the atrial switch operation will provide time for the neonate to gain weight for the operation.
- This technique will minimize the risk involved in moving the patient by reducing the need for transfer to the catheterization lab and exposure.
- Balloon Septostomy as compared to other techniques, is cost effective and safer.
- India has expertise in neonatal cardiologist and interventional proficients.
Complication of Balloon Septostomy in India
Some important complications of Balloon Septostomy in India are:
- Bleeding , arrhythmias and stroke
- Thrombosis in the femoral vein
- Cerebrovascular accident
- Cardiac tamponade
- Transient intracardiac thrombosis
- Hypovolemic shock
- Cutting of umbilical venous catheter
- Temporary heart rhythm disturbances
- Fragment embolization
- Ischemia of lower limbs
- Perforation of the heart, atrial appendage, or other structures
- Inadequate septostomy with poor oxygen saturation improvement
- Need for extracorporeal membrane oxygenation
- Anesthesia-related complications
Success of Balloon Septostomy
The rate of success of Balloon Septostomy in India is reported higher as compared to other nations. Cure percentage of Balloon septostomy is higher as 68.7%-70%.
Cost of Balloon Septostomy
The cost of Balloon Septostomy is less expensive as compared to other countries.
The variation of cost depends on many factors like, hospital charge, location, transport, Lab fee, and insurance coverage.
In many western countries the cost of treatment may be greater than India, in India the facilities and lower cost of treatment makes India more attractive and affordable treatment for Balloon Septostomy.
Summary
Through a blood vessel in the femoral vein or in the umbilical cord, the balloon tipped catheter was inserted. The balloon will be inserted to open the atrial septum by catheter insertion. The Balloon Septostomy will be performed in defects like, hypoplastic left heart syndrome, transposition of the great arteries and in restrictive septum limits blood supply.
In India the Balloon septostomy gives important and convenient intervention for neonates in congenital heart defects. In addition to this, Balloon Septostomy will increase oxygenation, stabilize pulmonary vascular resistance and distribute flexible surgical planning.
The Balloon Septostomy is affordable and easily available making it a good option.
