case_images: PMC10396523_01
case_images: Regular shape of the catheter with a straight tip, 80 cm long.
case_images: CRIC2023-9920336.002.jpg
case_images: PMC10396523_01_CRIC2023-9920336.002.jpg
case_images: fig2
case_images: Terumo 5 Fr radial sheath (the manufacturer recommends a 4 Fr sheath, but in our experience the balloon, when deflated after intervention, needs a 5 Fr sheath for extraction) with access from the right femoral vein (Figure 2).
case_images: Patient (32 weeks of gestation, 1.2 kg) with TGA, VSD, and restrictive ASD. Edwards Fogarty Fortis Catheter with straight tip.
case_images: CRIC2023-9920336.003.jpg
case_images: PMC10396523_01_CRIC2023-9920336.003.jpg
case_images: fig3
case_images: The catheter is of a single-lumen design with a stylet inside, but without an end-hole (Figures 3 and 4). The stylet allows for manual modification of the tip shape of the catheter (Figure 5).
case_images: Individually modified catheter tip according to the atrial anatomy of the patient (arrow).
case_images: CRIC2023-9920336.004.jpg
case_images: PMC10396523_01_CRIC2023-9920336.004.jpg
case_images: fig4
case_images: The catheter is of a single-lumen design with a stylet inside, but without an end-hole (Figures 3 and 4). The stylet allows for manual modification of the tip shape of the catheter (Figure 5).
case_images: Catheter and stylet shaped (arrows).
case_images: CRIC2023-9920336.005.jpg
case_images: PMC10396523_01_CRIC2023-9920336.005.jpg
case_images: fig5
case_images: The catheter is of a single-lumen design with a stylet inside, but without an end-hole (Figures 3 and 4). The stylet allows for manual modification of the tip shape of the catheter (Figure 5).
case_images: (a) Balloon with a volume of 0.75 cc saline inflated and a diameter of 0.6 cm. (b) Balloon with a volume of 1.5 cc of saline inflated and a diameter of 1.0 cm.
case_images: CRIC2023-9920336.006.jpg
case_images: PMC10396523_01_CRIC2023-9920336.006.jpg
case_images: fig6
case_images: After the removal of the stylet and balloon inflation with 0.75 cc of saline (Figure 6), BAS was performed without any complication. ASD seemed to be too small again (Figure 7), and a second and third BAS were performed by inflating 1 and 1.5 cc of saline into the balloon, respectively (Figures 6 and 8). After that, a 5 mm wide ASD was seen on echocardiography, and the intervention was stopped (Figure 9).
case_images: Echocardiography of atrial anatomy of the patient showing a severely dilated left atrium (star), a restrictive atrial septal defect (arrow), and a small right atrium (dot).
case_images: CRIC2023-9920336.007.jpg
case_images: PMC10396523_01_CRIC2023-9920336.007.jpg
case_images: fig7
case_images: ASD seemed to be too small again (Figure 7), and a second and third BAS were performed by inflating 1 and 1.5 cc of saline into the balloon, respectively (Figures 6 and 8). After that, a 5 mm wide ASD was seen on echocardiography, and the intervention was stopped (Figure 9).
case_images: Echocardiography of the same patient with the balloon inflated (arrow) in the left atrium (star). Dot: right atrium.
case_images: CRIC2023-9920336.008.jpg
case_images: PMC10396523_01_CRIC2023-9920336.008.jpg
case_images: fig8
case_images: ASD seemed to be too small again (Figure 7), and a second and third BAS were performed by inflating 1 and 1.5 cc of saline into the balloon, respectively (Figures 6 and 8). After that, a 5 mm wide ASD was seen on echocardiography, and the intervention was stopped (Figure 9).
case_images: Echocardiography after BAS: a large ASD with left-to-right-shunting is present (arrow); the left atrium is decompressed (star) and the right atrium is larger (dot).
case_images: CRIC2023-9920336.009.jpg
case_images: PMC10396523_01_CRIC2023-9920336.009.jpg
case_images: fig9
case_images: ASD seemed to be too small again (Figure 7), and a second and third BAS were performed by inflating 1 and 1.5 cc of saline into the balloon, respectively (Figures 6 and 8). After that, a 5 mm wide ASD was seen on echocardiography, and the intervention was stopped (Figure 9).