Atrial septostomy is a palliative medical procedure used to create or enlarge a hole (septal defect) between the atria, the two upper chambers of the heart. This is done to improve blood mixing between the oxygen-rich and oxygen-poor blood in patients with certain congenital heart defects, most commonly in cases of transposition of the great arteries (TGA) or severe pulmonary hypertension. By allowing blood to mix between the right and left atria, the procedure helps relieve pressure on the heart and improves oxygen delivery to the body. The need for an atrial septostomy arises primarily in congenital heart conditions like TGA, where the normal flow of oxygenated blood to the body is disrupted, or in cases of pulmonary hypertension, where increased pressure in the lungs puts strain on the right side of the heart. It is often performed as a temporary measure in newborns or infants who are awaiting corrective surgery, such as an arterial switch operation, or in adults with severe pulmonary hypertension who are not candidates for more definitive treatments. Symptoms that may indicate the need for an atrial septostomy include cyanosis (bluish discoloration of the skin due to low oxygen levels), difficulty breathing, fatigue, and failure to thrive in infants. In cases of pulmonary hypertension, patients may experience shortness of breath, chest pain, and dizziness. Atrial septostomy improves blood oxygen levels and relieves symptoms, offering temporary relief while more permanent treatments are planned or while stabilizing the patient's condition.
