Sangtawesin Chaisit, Layangkool Thanarat, Kirawitaya Thawatchai, Petchdamrongsakul Amornrat, Intasorn Chanisa, Noisaeng Puttha, Glundeema Sompun
Pediatric Cardiology Unit, Queen Sirikit National Institute of Child Health, Bangkok 10400, Thailand.
J Med Assoc Thai. 2003 Aug;86 Suppl 3:S517-21.
Balloon atrial septostomy (BAS) is a safe and effective palliative procedure for patients with cyanotic congenital heart disease. The first BAS in Thailand was performed in 1987 at our institute and there have been many changes since that time.
To evaluate the immediate and intermediate outcomes of BAS in the new century.
Thirty patients who underwent BAS from January to December 2001 were included in this study. Epidemiologic data, echocardiographic diagnosis, changing techniques from the previous report and the clinical course for patients were reviewed. The end point of follow-up for this study was December 2002.
Thirty patients underwent BAS from January to December 2001 with an age range from 1 to 213 days (mean 30.40 +/- 41.97 days). BAS was selectively tried via the umbilical vein in 6 cases. This was successful in 4 cases. Others were performed successfully via the femoral vein. The most common diagnoses were complete transposition of the great arteries (TGA), pulmonary atresia (PA) with intact ventricular septumand transposition of the great arteries with ventricular septal defect (TGA, VSD) respectively. No immediate complications were found in the present study. There were 5 deaths prior to surgery and 2 post-operative deaths accounting for a total mortality of 23.3 per cent.
BAS is a safe and effective palliative procedure for patients with various types of cyanotic congenital heart disease even in infants up to 7 months of age. The umbilical venous route can be used effectively without significant problems. Although the overall mortality is high, it is not related to BAS.
球囊房间隔造口术（BAS）是治疗青紫型先天性心脏病患者的一种安全有效的姑息性手术。泰国首例BAS于1987年在我院实施，自那时起已有许多变化。
评估新世纪BAS的近期和中期结果。
本研究纳入了2001年1月至12月接受BAS的30例患者。回顾了患者的流行病学数据、超声心动图诊断、与之前报告相比技术的变化以及临床病程。本研究的随访终点为2002年12月。
2001年1月至12月，30例患者接受了BAS，年龄范围为1至213天（平均30.40±41.97天）。6例患者经脐静脉选择性尝试BAS，其中4例成功，其他患者经股静脉成功完成手术。最常见的诊断分别是完全性大动脉转位（TGA）、室间隔完整的肺动脉闭锁（PA）以及合并室间隔缺损的大动脉转位（TGA，VSD）。本研究未发现即刻并发症。术前有5例死亡，术后有2例死亡，总死亡率为23.3%。
BAS对于各类青紫型先天性心脏病患者，即使是7个月龄以内的婴儿，也是一种安全有效的姑息性手术。脐静脉途径可有效使用且无明显问题。尽管总体死亡率较高，但与BAS无关。
