Balloon atrial septostomy in infants with transposition of the great arteries (d-TGA): PGIMER experience.

Experience in use of Balloon Atrial Septostomy (BAS) in the palliation of infants with TGA is scanty from developing countries. We report 53 infants of d-TGA palliated with BAS in the period 1972 - 88 (mean age 2.03 +/- 1.32 months, mean weight 3.44 +/- 0.58 kg). 44 infants had an intact ventricular septum. The mean pre-BAS systemic oxygen saturation was 37.29 +/- 8.41% which rose to 53 +/- 13.6% after a successful septostomy. The procedure was successful in 83% of the infants and caused 3 deaths (5.7%) all part of our early experience. Balloon deflation failure (1) was encountered only in the earlier years. Follow up is available in 30 infants upto 2.8 years. Cynosis and congestive failure improved uniformly post procedure. The improvement was maintained at an average of 5 months. 5 deaths (16%) occurred at an average of 7.6 months. 5 patients underwent definitive repair. We conclude that BAS is safe and effective in palliation of infants with d-TGA and that the gain with BAS is at best a temporary measure before definitive surgery.