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ARTICLE | September 1968

Atrial Septotome for Palliative Septectomy in Infants With Transposition of the Great Vessels

Eric W. Fonkalsrud, MD; Jorge A. Tocornal, MD

Arch Surg. 1968;97(3):514-516. doi:10.1001/archsurg.1968.01340030174019.

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SINCE approximately 90% of the infants with untreated transposition of the great vessels die before they reach the age of 6 months, palliation should be undertaken early in most cases.¹ The basic concept of atrial septectomy to facilitate intracardiac mixing described by Blalock and Hanlon in 1950² remains the standard method of palliation, although numerous modifications in technique have been developed because of the discouragingly high operative mortality.

Balloon dilatation of the foramen ovale with a cardiac catheter has recently lowered the risk of palliative atrial septotomy to less than 20%.³ However, in many cases the torn edges of the foramen ovale approximate and become thickened from scarring again within several weeks. Subsequent redilatation of the foramen ovale with a balloon catheter is more hazardous and may again be followed by stenosis of the septal defect.

This report describes an operative technique of atrial septectomy without

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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Fonkalsrud EW, Tocornal JA. Atrial Septotome for Palliative Septectomy in Infants With Transposition of the Great Vessels. Arch Surg. 1968;97(3):514-516. doi:10.1001/archsurg.1968.01340030174019.

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