In 1966, American surgeons William Rashkind and William Miller transformed the palliation of d-TGA patients with the innovative " Rashkind balloon atrial septostomy ", which, unlike the thoracotomy required by a septectomy, is performed through the minimally invasive surgical technique of cardiac catheterization.
12.
A balloon atrial septostomy is performed with a balloon catheter, which is inserted into a patent foramen ovale ( PFO ), or atrial septal defect ( ASD ) and inflated to enlarge the opening in the atrial septum; this creates a shunt which allows a larger amount of oxygenated ( " red " ) blood to enter the systemic circulation.
13.
The HLM is turned off and the aortic and atrial cannula are removed, then an incision is made in the right atrium, through which the congenital or palliative atrial septal defect ( "'ASD "') is repaired; where a Rashkind balloon atrial septostomy was used, the ASD should be able to be closed with sutures, but cases involving large congenital ASDs or Blalock-Hanlon atrial septectomy, a pericardial, xenograft, or Dacron patch may be necessary.
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