A Neonate With TGA and Restrictive Foramen Ovale: How to Apply Ordinary Catheterization Through the Umbilical Vein to Rescue the Neonate, a Case Report

Abstract

Transposition of the great vessels (TGA), particularly with a restrictive foramen ovale (FO), constitutes a direct threat to neonatal life in the first hours of life. Poor mixing of oxygenated and deoxygenated blood leads to severe cyanosis and death. Administration of prostaglandin E1 (Alprostadil) to maintain the patency of the arterial duct allows an increase of the pulmonary blood flow and its return to the left atrium. In cases of TGA with restricted interatrial communication, higher pressure in the left atrium causes closing of the FO flap and better mixing cannot be achieved. In such cases, urgent balloon atrial septostomy (BAS - Rashkind procedure) is the method of choice. It enables mixing of the blood and survival of the child until the surgical procedure can be performed. We present the case of a neonate in whom the FO flap was opened by introducing an ordinary catheter (3.5 French) via the umbilical vein. The procedure was performed, with good effect, at a neonatal center that had no facilities for invasive cardiology treatment.




J Med Cases. 2014;5(10):529-531
doi: http://dx.doi.org/10.14740/jmc1853w