Balloon atrial septostomy by a right internal jugular venous approach in a newborn with hypoplastic left heart syndrome with a restrictive atrial septum.

Hypoplastic left heart syndrome with an intact or highly restrictive atrial septum requires urgent decompression of the left atrium. Catheter-based interventions from the femoral or umbilical veins represent the standard method of atrial decompression. Restrictive atrial septal defects located at the superior portion of the fossa ovalis can be difficult to cross from these access sites. Here, we describe a successful Rashkind balloon atrial septostomy performed from an internal jugular approach.