April 1970

Transumbilical Atrial Septostomy in the Newborn

Author Affiliations

Haifa, Israel
From the departments of cardiology and neonatal pediatrics, Rambam Government Hospital, Haifa, Israel.

Am J Dis Child. 1970;119(4):354-356. doi:10.1001/archpedi.1970.02100050356016

Complete transposition of the great vessels occurs in about 9% of all newborns with cardiovascular malformations.1 It is one of the leading causes of death from congenital heart disease in infancy. The majority of cases with intact ventricular septum die within the first month of life.2 Only a few survive long enough to allow surgical corrective procedures such as Mustard's operation3 unless there has been previous palliative intervention. The palliative procedure of choice in patients with an effective interventricular or inter atrial communication is the surgical creation of an atrial septal defect.4 Even such a palhative operation carries a high mortahty of up to 50%,2 as it entails a general anesthetic and thoracotomy in an anoxic infant with cardiac decompensation and often acidosis.

Rashkind and Miller,5 in 1966, described an effective method of atrial septostomy without thoracotomy, using a balloon catheter introduced through

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