What Is a Balloon Septostomy?

Jillian O Keeffe

A balloon septostomy is a type of heart operation, typically performed on young children with developmental abnormalities in the heart. During this operation, a surgeon inserts a small balloon into the heart to widen a passage for blood to get through. This allows the heart to work more efficiently than before, but as a temporary measure before more complex surgery can be attempted.

A septostomy is a surgical procedure done on hearts of young children with developmental abnormalities.
A septostomy is a surgical procedure done on hearts of young children with developmental abnormalities.

The heart is basically a pump for blood which moves around the body, transporting nutrients and oxygen to all the body's vital organs. There are two main directions of blood, away from the lungs with oxygen, and toward the lungs with carbon dioxide. The heart is composed of chambers; one side of the heart contains blood with oxygen, while the other contains deoxygenated blood.

At the time of birth, the pressure inside the baby's heart typically forces a flap of tissue over the foramen ovale.
At the time of birth, the pressure inside the baby's heart typically forces a flap of tissue over the foramen ovale.

Each heart is made up of four chambers; the top two are called atria and the bottom two are ventricles. Blood of each type moves through separate chambers, so the oxygenated and the non-oxygenated blood do not mix. Sometimes, during pregnancy, the development of the heart does not occur as normal, and this can result in swapping over of the vessels attached to the heart. To help alleviate problems caused by blood mixup, surgeons can exploit existing holes in the heart. These are foramen ovale, which represent holes between the two atria that are present in all newborn babies, and normally close over within a few days.

Developmental heart problems can cause the baby to be deprived of oxygen, as the blood does not travel around the body properly, and it may be mixed up with deoxygenated blood. Cardiac surgeons can help the blood to move more normally by enlarging existing holes in the affected area, to channel blood in alternate ways. A balloon septostomy is an example of one of these operations, which involves the foramen ovale.

Before the foramen ovale close over within a few days of birth, the hole allows oxygenated blood to move into the correct chamber. Enlargement of the hole helps aid this movement, as surgeons use the balloon septostomy to stretch the hole with an inflated balloon. Initially, the balloon is deflated, and inserted into the circulatory system through a cut in the groin, before being threaded through the vessels into the atrium. After entering the heart, the surgeon places the balloon through the foramen ovale, inflates the balloon and then retracts it back into the opposite atrium, thus making the hole larger. A balloon septostomy operation is a temporary fix to a larger issue, which may require reconstructive surgery as well.

During a balloon septostomy, a surgeon inserts a small balloon into the heart to widen a passage for blood to get through.
During a balloon septostomy, a surgeon inserts a small balloon into the heart to widen a passage for blood to get through.

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