Closed atrial septectomy with brock punch aided by operative transesophageal echocardiography

A 5-week-old infant with mitral atresia and double-outlet right ventricle underwent blade atrial septostomy complicated by cardiac tamponade. Surgical septectomy was performed using a Brock punch aided by intraoperative transesophageal echocardiography. This was well tolerated, and the adequacy of the septectomy could be assessed immediately.