Chandrashekhar Y S, Khattri H N, Bidwai P S
Dept. of Cardiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Indian Heart J. 1990 Jan-Feb;42(1):51-4.
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.
在发展中国家，关于使用球囊房间隔造口术（BAS）姑息治疗大动脉转位（TGA）婴儿的经验很少。我们报告了1972年至1988年期间53例接受BAS姑息治疗的右型TGA婴儿（平均年龄2.03±1.32个月，平均体重3.44±0.58千克）。44例婴儿室间隔完整。BAS术前体循环血氧饱和度平均为37.29±8.41%，成功造口术后升至53±13.6%。该手术在83%的婴儿中成功，导致3例死亡（5.7%），均为我们早期经验的一部分。球囊放气失败（1例）仅在早期出现。30例婴儿得到了长达2.8年的随访。术后青紫和充血性心力衰竭均有改善。改善平均维持了5个月。5例（16%）死亡，平均发生在7.6个月时。5例患者接受了根治性修复。我们得出结论，BAS在姑息治疗右型TGA婴儿方面是安全有效的，并且BAS带来的益处充其量只是根治性手术前的临时措施。
