Off-Pump Atrial Septectomy for Infants With Restrictive Atrial Septal Defect.

Fuchigami, Tai; Nishioka, Masahiko; Akashige, Toru; Higa, Shotaro; Nagata, Nobuhiro · Ann Thorac Surg · 2017

case_report · Level V

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Abstract

The management of some subsets of patients with an unsuccessful balloon atrial septostomy (BAS) and poor general condition is typically challenging. Our novel technique involves off-pump atrial septectomy using laparoscopic forceps guided by intraoperative direct pericardial echocardiography. The technique was first used in a case of tricuspid atresia in a patient in preshock and was then used in 2 more patients with hypoplastic left heart syndrome (HLHS) (age, 10-116 days; body weight, 2.4-3.7 kg). There were no operative complications of embolism or bleeding in our series. Our off-pump atrial septectomy technique is an effective approach in specific cases.

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