Maksymenko A. Balloon atrial septostomy under echocardiographic guidance in newborns with congenital heart defects.

This thesis is the first study in the Ukraine to elaborate the experience of performing interventional cardiac procedures utilizing alternative methods of visualization, without application of fluoroscopy. The study is aimed at improvement in accessibility and safety of urgent interventional procedures in newborns with critical congenital heart disease (CHD) by means of refinement in current techniques and introduction of atrial septostomy (ASS) under fluoroscopic- and echocardiographic guidance. Techniques and results of ASS were investigated in a group of 189 newborns. A role of ASS in hemodynamic changes is examined; indications and contraindications for different techniques of ASS are elaborated and proved; criteria to estimate efficiency of ASS under echocardiographic guidance are presented; comparative analysis of ASS under different guidance techniques is performed. Introduction of the results of the study allowed: to perform urgent ASS out of catheterization laboratory and specialized cardiac clinic; to reduce exposure of neonates to X-rays and contrast agents; to decrease twice the number of complications and completely avoid procedure-related mortality.