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BAS – TGA — RACP Paediatrics MCQ

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ModerateCardiologyBAS – TGARACP Paediatrics

A newborn with d-TGA has severe cyanosis (SpO2 45%) despite prostaglandin E1 infusion. Echocardiography shows a restrictive atrial septum with poor mixing. The arterial switch operation is planned for tomorrow. What urgent catheter intervention is needed?

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Correct answer: B — Balloon atrial septostomy

Balloon atrial septostomy (Rashkind procedure) creates or enlarges the interatrial communication to improve mixing of oxygenated and deoxygenated blood in TGA. It is a life-saving intervention when the atrial septum is restrictive and prostaglandins alone cannot maintain adequate oxygenation. It is performed at the bedside or in the catheterisation laboratory.

Reference: RCH Melbourne – 2023 – Cyanotic Newborn CPG; RACP Paediatric Curriculum – Cardiology