Transcatheter Cardiac Interventions in Neonates with Congenital Heart Disease: A Single Centre Experience

Objective: To analyze the outcome among neonates undergoing transcatheter balloon atrial septostomy for various kinds of congenital heart diseases. Study Design: Prospective longitudinal study. Place and Duration of Study: National Institute of Cardiovascular Diseases, Karachi Pakistan, from Feb 2020 to May 2021. Methodology: A total of 28 neonates of both genders with echocardiography proven diagnosis of Tricuspid Atresia with restrictive Patent Foramen Ovale, Dextro-Transposition of Great Arteries with Intact Ventricular Septum, complex cyanotic congenital heart disease with inadequate mixing or hypoplastic left heart syndrome with restrictive PFO and a non-significant Patent Ductus Arteriosus, undergoing transcatheter balloon atrial septostomy were included. Demographic data along with diagnosis, clinical presentation, echocardiographic findings, procedural outcome (successful/unsuccessful), duration of the procedure, complication (if any), post-procedural echocardiographic findings, duration of hospital stay, further treatment plan and 3-months follow up outcomes were recorded among all neonates. Results: Most common diagnosis was Dextro-Transposition of the Great Arteries with IVS observed in 14(50.0%) neonates. Procedural outcome was found to be successful among 23(82.1%) neonates. There were 19(67.9%) neonates who did not show any post-procedure complication. At 3-months follow up, improvement in blood saturation and weight gain were reported among 12(42.9%) neonates each. Overall, mortality was noted in 7(25.0%) neonates, of whom 4(57.1%) neonates were having hypoplastic left heart syndrome. Conclusion: Transcatheter atrial septostomy done in neonatal period was found to have positive outcomes. Mortality remains high among neonates undergoing transcatheter atrial septostomy having hypoplastic left heart syndrome.