[Balloon atrioseptostomy (B.A.S.) in the management of neonates and infants with transposition of great vessels (author's transl)].

From June 1969 to April 1973, B.A.S. was carried out in 2-day to 6-month-old 65 infants at the Institute of Paediatrics of the Academy of Medicine in Warsaw. There were 16 infants up to one week old, 39 infants--up to one month, and 10 infants more than one month old. There were 43 boys and 22 girls among them. Cardiac catheterization and B.A.S. were carried out in most children up to 24 hours following hospitalization under local anaesthesia and premedication with robenzperidol and dolantin. In 11 of the 65 infants after B.A.S. the saturation with oxygen in the right atrium under-went no significant changes; in 54 cases it increased by 10 to 49 per cent. Of the 65 infants in whom B.A.S. was performed, 37 are alive, 28 had died. In 20 children under constant outpatient cardiological follow up the observation period has amounted from 6 months to 3 years. Their motoric development and growth is retarded, there is moderate cyanosis, but no symptoms of congestive failure were found. All these children are administered digitalis in chronic maintenance doses. Respiratory infections occured frequently in these patients. As mentioned above, 28 infants died at the age of 2 days to 6 months. Post mortem examination revealed that the B.A.S. was unsufficient in 14 cases. However, 14 infants died in spite of the satisfactority performed atrioseptostomy. Pulmonary oedema or haemorrhagic-and-inflammatory changes in the lungs as well as generalized thrombosis were the most frequent causes of death. On the basis of their own experience the authors elaborated indications and instructions for B.A.S. in neonates and infants with congenital heart diseases. These directives are based on the Team Work of cardiologists, anaesthesiologists, cardiac surgeons and paediatric radiologists. Because ever greater numbers of neonates are being sent to the Institute of Paediatric of the Academy of Medicine from all over Poland, the authors organized continuous cardiological emergency service to carry out B.A.S. procedures as soon as possible, without delay.