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Infants with congenital heart abnormalities can survive until they have corrective surgery with the use of a septostomy. The Rashkind procedure or balloon atrial septostomy is another term for septostomy. Because it affects the atria, the two upper chambers of the infant's heart, the treatment is referred to as "atrial."
A small opening in the septum of a fetus is called the foramen ovale. The wall separating their heart's left and right halves is called the septum. Blood can move from the right side of the fetus's heart to the left side through the foramen ovale. A balloon catheter is used during the septostomy procedure to enlarge the foramen ovale and permit blood from both sides of the heart to mix. Thus, blood with and without oxygen combine. To give the baby enough time for surgery, the method maintains the foramen ovale open.
This is a percutaneous technique, which means that a medical professional will penetrate the skin with a needle and implant a catheter. A balloon within the catheter enlarges a hole that exists naturally in the infant's heart. Blood with more oxygen can mingle with blood with less oxygen through this opening. The baby's body can then begin to circulate this partially oxygenated blood after it has left the heart. The infant's blood would simply be low in oxygen flowing through their body without this pathway.
A Septostomy is not exactly an open cardiac surgery. Rather, it's an interim solution to bridge the time between birth and surgery.
General classification of Septostomy:
- Balloon atrial septostomy (BAS)- is a medical procedure used mostly in cases of poor mixing of oxygenated and deoxygenated blood at the atrial level, such as transposition of the great arteries (TGA).
- Rashkind Balloon Atrial Septostomy- Applied only to infants with intact ventricular septum and transplacental ablation.
- Blade Atrial Septostomy- Applied in difficult situations when balloon procedures are impractical or ineffective.
- Surgical atrial septostomy- Taken into consideration when catheter-based methods are impractical or have not worked.
Septostomy is required by:
- Some cyanotic heart abnormalities in infants may require a septostomy. These are abnormalities that stop the infant's blood which is low in oxygen from getting to its lungs to receive more oxygen hence, the body's tissues are deprived of oxygen when this occurs. Their skin turns blue due to oxygen deprivation (cyanosis). It is extremely dangerous, severe cyanosis requires emergency medical attention.
- Some medications, including prostaglandin E1, may be given to infants with these conditions to help them breathe better.
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