0353 : Cerebral tissue oxygen saturation monitoring during balloon atrial septostomy in neonates with transposition of the great arteries. Preliminary data

Abstract

Balloon atrial septostomy (BAS) increases peripheral oxygen saturation in neonates with transposition of the great vessels (TGV). Effect of BAS on cerebral oxygenation remains little known. We aimed to describe the modification of regional cerebral tissue oxygen saturation (rcSaO 2 ) during the catheterization. we prospectively included 6 neonates with TGV and restrictive inter-atrial shunt who required BAS. BAS was performed in catheterization laboratory by an interventional pediatric cardiologist. rcSaO 2 was measured using near-infrared spectroscopy (NIRS) during the whole procedure. Median rcSa0 2 at the beginning of the procedure was 52.5% ranging from 21% to 78%. Median rcSaSaO 2 after the BAS was 69.5% ranging from 64% to 94%. The rcSa0 2 increased significantly immediately after the BAS (p=0.0273 by Wilcoxon signed rank test). Median rcSa0 2 delta between before and after BAS was 19% ranging from 11 to 43%. The rcSaO 2 delta was higher although not significantly when rcSa02 before the BAS was less than 50% (31% vs 16%, p=0.14). Linear regression analysis revealed that the delta of rcSaO 2 was significantly inversely related to the rcSa0 2 at the beginning of the procedure (Delta= –0.45 x rcSaO 2 av + 45.8, p=0.37, R 2 =0.70). BAS improves cerebral oxygen saturation during the catheterization in neonates with TGV and restrictive inter-atrial shunt. The increase is proportional to the degree of alteration before the procedure.