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Rashkind Septostomy — RACP Paediatrics MCQ

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HardCardiologyRashkind SeptostomyRACP Paediatrics

A newborn presents with central cyanosis and a single loud S2. Echocardiogram shows the pulmonary artery arising from the left ventricle and the aorta arising from the right ventricle with parallel great arteries. The atrial septum is restrictive. What urgent intervention is required?

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Correct answer: A — Balloon atrial septostomy (Rashkind procedure)

In TGA with restrictive atrial septum, mixing is inadequate and the infant is severely cyanotic. Balloon atrial septostomy (Rashkind procedure) creates a larger atrial communication to allow better mixing. PGE1 may also help by maintaining ductal patency. Definitive repair (arterial switch) follows.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: TGA