Balloon atrial septostomy in end-stage pulmonary hypertension guided by a novel intracardiac echocardiographic transducer

Blade and balloon atrial septostomy has been used to reduce cardiopulmonary symptoms and as a bridge to lung or heart lung transplant in primary pulmo nary hypertension. Due to severe right atrial dilatation and resultant loss of anatomical landmarks, the procedure is technically difficult, and the r eported postprocedure mortality rate varies between 5% and 50%, Among other s, marked systemic desaturation and systemic hypotension presumably seconda ry to an excessively large atrial septal defect have been reported as cause s of postprocedure death. We report a case where a novel intracardiac cathe ter-based phased-array 5.5-10 MHz transducer with spectral and color-flow D oppler capabilities was used to assist a balloon atrial septostomy and to o btain hemodynamic data in a patient with end-stage pulmonary hypertension. (C) 2001 Wiley-Liss, Inc.