Novel transatrial septoplasty technique for neonates with hypoplastic left heart syndrome and an intact or highly restrictive atrial septum.

Two patients born with hypoplastic left heart syndrome and an intact or highly restrictive atrial septum requiring emergent intervention are presented. For both patients, rapid septoplasty was performed using a hybrid approach involving direct atrial puncture and transatrial cutting balloon dilation of the atrial septum. This technique facilitates safe and rapid procedural completion and minimizes the risk of procedural complications in this very-high-risk patient population.