Rashkind maneuvers

The Rashkind maneuver for tricuspid atresia

The Rashkind maneuver or Rashkind balloon atrial septostomy (Syn: Rashkind atrioseptostomy, balloon septostomy), named after the American pediatric cardiologist WJ Rashkind, is a palliative cardiac catheter procedure in pediatric cardiology. The atrial septum is torn with the help of a balloon catheter in order to create an artificial atrial septal defect with a subsequent shunt . This creates a hemodynamic situation that is compatible with life and enables a child with a heart defect that obstructs normal blood flow without simultaneously effective atrial or ventricular septal defects (for example, single-chamber hearts ) to survive until surgery.

This procedure is performed on newborns, whose prenatal circulatory connections foramen ovale and ductus botalli close postnatally and thereby - in connection with the heart malformation - prevent the vital blood flow. Usually from birth or postnatal diagnosis by administering alprostadil or similar, this development is inhibited until the intervention, in order then to establish a fixed state with the Rashkind maneuver until further measures (such as Blalock-Taussig anastomosis ).

A balloon catheter that has not yet been expanded is advanced through the right atrium and the remaining foramen ovale into the left atrium. The balloon is then filled with physiological saline solution, which prevents both compression on withdrawal and an embolic complication in the event of a catheter defect. The filled balloon is then suddenly withdrawn through the foramen ovale, so that the atrial septum ruptures and a permanent septal defect arises.

Sources and literature

Mewis, Riessen, Spyridopoulos (eds.): Kardiologie compact . 2nd Edition. Thieme, Stuttgart, New York 2006, ISBN 3-13-130742-0 , pp. 492 .
Reinhard Larsen: Anesthesia and intensive medicine in cardiac, thoracic and vascular surgery. (1st edition 1986) 5th edition. Springer, Berlin / Heidelberg / New York et al. 1999, ISBN 3-540-65024-5 , p. 341.

Individual evidence

^ Henry R. Wagner: Bill Rashkind's contribution to pediatric cardiology . In: Transposition of the Great Arteries 25 years after Rashkind Balloon Septostomy . Steinkopff, Heidelberg 1992, ISBN 978-3-7985-0895-8 , pp. 1–4 , doi : 10.1007 / 978-3-642-72472-5_1 ( springer.com [accessed April 6, 2019]).

[1] Henry R. Wagner: Bill Rashkind's contribution to pediatric cardiology . In: Transposition of the Great Arteries 25 years after Rashkind Balloon Septostomy . Steinkopff, Heidelberg 1992, ISBN 978-3-7985-0895-8 , pp. 1–4 , doi : 10.1007 / 978-3-642-72472-5_1 ( springer.com [accessed April 6, 2019]).