2,364 results match your criteria transseptal

Pulmonary Vein Isolation With Ablation Index via Single Transseptal Crossing: Critical Role of Carina Isolation.

Heart Lung Circ 2021 Apr 13. Epub 2021 Apr 13.

Department of Cardiology, Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Aim: Reconnection of the pulmonary veins (PVs) is the most common reason for the recurrence of atrial fibrillation (AF). The ablation index is a marker of ablation lesion quality that achieves high percentages of first-pass isolation and improved AF ablation results. Most operators use a double transseptal approach with confirmation of PV isolation with a circular mapping catheter. Read More

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Successful radiofrequency perforation and balloon decompression of cor triatriatum sinister using novel technique, a case series.

Catheter Cardiovasc Interv 2021 Apr 15. Epub 2021 Apr 15.

UCLA Mattel Children's Hospital, Los Angeles, California, USA.

Cor triatriatum sinister (CTS) is a rare congenital cardiac anomaly representing <0.1% of all congenital cardiac malformations. It is characterized by the presence of a left atrial (LA) membrane that leads to left ventricular inflow obstruction. Read More

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Clinical Effect of Adaptive Servo-Ventilation on Left Atrial Pressure During Catheter Ablation in Sedated Patients With Atrial Fibrillation.

Circ J 2021 Apr 13. Epub 2021 Apr 13.

Department of Cardiology, Tokyo Medical and Dental University.

Background: Sedation during pulmonary vein isolation (PVI) for atrial fibrillation often provokes a decline in left atrial (LA) pressure (LAP) under atmospheric pressure and increases the risk of systemic air embolisms. This study aimed to investigate the efficacy of adaptive servo-ventilation (ASV) on the LAP in sedated patients.Methods and Results:Fifty-one consecutive patients undergoing cryoballoon PVI were enrolled. Read More

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Tipless Transseptal Cannula Concept Combines Improved Hemodynamic Properties and Risk-Reduced Placement: an In Silico Proof-of-Concept.

Artif Organs 2021 Apr 13. Epub 2021 Apr 13.

ReCO2very Therapies GmbH, Bad Klosterlausnitz, Germany.

As a leading cause of death worldwide, heart failure is a serious medical condition in which many critically ill patients require temporary mechanical circulatory support (MCS) as a bridge-to-recovery or bridge-to-decision. In many cases, the TandemHeart® system is used to unload the left heart by draining blood from the left atrium (LA) to the femoral artery via a transseptal multistage cannula. However, even though correct positioning of the cannula is crucial for a safe treatment, the long cannula tip currently used in transseptal cannulas complicates positioning, making the cannula moreover vulnerable to displacement during MCS. Read More

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Pseudothrombotic appearance on pulmonary valve by intracardiac echocardiography during atrial fibrillation ablation.

J Arrhythm 2021 Apr 23;37(2):448-449. Epub 2020 Nov 23.

Division of Cardiology Internal Medicine Ⅲ Hamamatsu University School of Medicine Hamamatsu Japan.

We report a case with a thrombus-like image on pulmonary valve detected by intracardiac echocardiography before transseptal puncture for atrial fibrillation (AF) ablation. The multimodality assessment provided diagnosis of the imaging artifact and exclusion from the harmful mass. This finding could be useful for a safety management of AF ablation and avoidance of an unnecessary interruption of the procedure. Read More

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Endonasal resection of orbital cavernous venous malformations with septal preservation.

Am J Otolaryngol 2021 Apr 5:103021. Epub 2021 Apr 5.

Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA. Electronic address:

Purpose: Multiple surgical approaches have been described to maximize visualization and accessibility for resection while minimizing morbidity in the patient with orbital intraconal tumors. Transnasal endoscopic approaches have become increasingly standard in select orbital cavernous venous malformations but often require a partial septectomy. The purpose of this manuscript is to communicate a septal preserving modified transseptal approach. Read More

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Aortic Regurgitation as a Complication of Electrophysiologic Ablation Techniques: A narrative review.

Curr Cardiol Rev 2021 Apr 7. Epub 2021 Apr 7.

Cardiology Dept., Al-Azhar University, Cairo. Egypt.

Background: Radiofrequency catheter ablation is a well-established treatment for several cardiac arrhythmias. Arrhythmias originating from the left side of the heart including ventricular and supraventricular tachycardia and ectopy can be successfully ablated through either transseptal or retrograde aortic approach. Although these techniques have a generally low rate of complications, aortic valve injury is a potential complication of ablation at the left cardiac side that warrants more investigation. Read More

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Feasibility and safety of left atrial appendage closure in a patient with previous foramen ovale occlusion: a case report.

Eur Heart J Case Rep 2021 Mar 31;5(3):ytab113. Epub 2021 Mar 31.

Cardiology Division, Sant'Andrea Hospital, Corso Mario Abbiate 21, 13100, Vercelli, Italy.

Background: Left atrial appendage (LAA) closure is an alternative to chronic oral anticoagulation for stroke prevention in patients with atrial fibrillation (AF) at high bleeding risk. Patients with a previous percutaneous closure of a patent foramen ovale (PFO) present an increased risk for developing AF during their life, and the presence of an atrial septal device renders future percutaneous left atrial access more challenging. Very few cases of LAA occlusion in patients with a preexisting PFO closure device have been previously reported. Read More

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Correction to: Transcatheter Mitral Valve Implantation Systematic Review: Focuson Transseptal Approach and Mitral Annulus Calcification.

Curr Cardiol Rep 2021 Apr 3;23(4):51. Epub 2021 Apr 3.

Service Médico-Chirurgical: Valvulopathies- Chirurgie Cardiaque-Cardiologie Interventionelle Structurelle, Hôpital Cardiologique de Haut Lévèque, CHU-Bordeaux, Bordeaux, France.

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A new over-the-wire percutaneous mitral balloon valvuloplasty technique.

Catheter Cardiovasc Interv 2021 Mar 31. Epub 2021 Mar 31.

Division of Cardiology, Tygerberg Hospital & Stellenbosch University, Cape Town, South Africa.

Objectives: To develop and evaluate a new over-the-wire technique for mitral valvuloplasty that is both technically easier and less costly.

Background: Rheumatic heart disease (RHD) and resultant mitral stenosis (MS) carries a significant burden of disease worldwide. The prevalence is however concentrated in lower income countries where the current gold standard for percutaneous mitral valvuloplasty (PMBV)-the Inoue technique, is not always available due to cost and technical complexity. Read More

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Transseptal puncture: procedural guidance, challenging situations and complications management.

EuroIntervention 2021 Mar 30. Epub 2021 Mar 30.

University Hospital, Zurich, Switzerland.

A number of interventional procedures based on the transseptal puncture (TSP) have been developed over the last years. The increasing number of interventional procedures, as well as the use of large-bore sheaths and complex devices, has led to improvements in technique and equipment. The combined use of fluoroscopy and of trans-esophageal echocardiography (TEE) has increased safety and precision. Read More

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Center procedural volume and adverse in-hospital outcomes for patients undergoing percutaneous transvenous edge-to-edge mitral valve repair using MitraClip® technique in Germany.

Eur J Heart Fail 2021 Mar 23. Epub 2021 Mar 23.

Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany.

Aims: The number of transcatheter mitral valve repairs increased substantially during last years. A better understanding of the relationship between hospital volume of transcatheter transvenous mitral valve repairs using MitraClip® (TMVr) and patient outcomes may provide information for future policy decisions to improve patients´ management.

Methods And Results: We analysed patients' characteristics and in-hospital outcomes for all TMVr using MitraClip® performed in Germany 2011-2017. Read More

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Pre-Operative Continued Oral Anticoagulation Impact on Early Outcomes after Transcatheter Aortic Valve Implantation.

Am J Cardiol 2021 Mar 20. Epub 2021 Mar 20.

Cardiac Surgery Department, University Hospital of Zurich, Zurich, Switzerland.

Considering that there is a lack of evidence and guideline-based recommendations on the best preoperative oral anticoagulation management (OAC) for transcatheter aortic valve implantation (TAVI), this cohort study aimed to evaluate bleeding, access site complications, and early safety in patients undergoing TAVI on continued OAC therapy vs no-OAC therapy. Three-hundred forty-four patients submitted to a TAVI procedure (66.3% no-OAC vs 33. Read More

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Arthroscopic anatomy of the posterolateral corner of the knee: anatomic relations and arthroscopic approaches.

Arch Orthop Trauma Surg 2021 Mar 22. Epub 2021 Mar 22.

Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.

Introduction: Although open-surgical techniques for the reconstruction of the posterolateral corner (PLC) are well established, the use of arthroscopic procedures has recently increased. When compared with open surgical preparation, arthroscopic orientation in the PLC is challenging and anatomic relations may not be familiar. Nevertheless, a profound knowledge of anatomic key structures and possible structures at risk as well as technical variations of arthroscopic approaches are mandatory to allow a precise and safe surgical intervention. Read More

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Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches.

J Interv Cardiol 2021 2;2021:6630774. Epub 2021 Mar 2.

Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China.

Objectives: The purpose of this study was to review the experiences with transcatheter closure of mitral PVL after surgical valve replacement.

Background: Transcatheter closure of paravalvular leak (PVL) is an intricate alternative to surgical closure. But it represents one of the most intricate procedures in the field of structural heart interventions, especially for patients with mitral PVL. Read More

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Surgical and Transcatheter Mitral Valve Replacement in Mitral Annular Calcification: A Systematic Review.

J Am Heart Assoc 2021 Apr 17;10(7):e018514. Epub 2021 Mar 17.

Department of Cardiovascular Surgery Mount Sinai Health System New York NY.

Mitral annular calcification with mitral valve disease is a challenging problem that could necessitate surgical mitral valve replacement (SMVR). Transcatheter mitral valve replacement (TMVR) is emerging as a feasible alternative in high-risk patients with appropriate anatomy. PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched from inception to December 25, 2019 for studies discussing SMVR or TMVR in patients with mitral annular calcification; 27 of 1539 articles were selected for final review. Read More

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Transbrachial Access for Transcatheter Closure of Paravalvular Leak Following Prosthetic Valve Replacement.

Front Cardiovasc Med 2021 26;8:589947. Epub 2021 Feb 26.

Center of Structural Heart Disease, National Center for Cardiovascular Diseases, Chinese Academic of Medical Science and Peking Union Medical College, Fuwai Hospital, Beijing, China.

Transcatheter closure of paravalvular leak (PVL) has evolved into an alternative to surgery in high-risk patients. In this study, we introduce a new access for transcatheter closure of PVL and seek to evaluate the feasibility and safety of this access. We retrospectively analyzed patients undergoing transbrachial access for transcatheter mitral or aortic PVL closure (August 2017-November 2019) at our hospital. Read More

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February 2021

Iatrogenic atrial septal defect after percutaneous left atrial appendage closure: a single-center study.

Int J Cardiovasc Imaging 2021 Mar 14. Epub 2021 Mar 14.

Cardiology Department, Centro Hospitalar e universitário de Coimbra - Hospital Geral, Quinta dos Vales - São Martinho do Bispo, 3043-853, Coimbra, Portugal.

There is conflicting evidence regarding the significance of iatrogenic atrial septal defects (iASDs) after transseptal puncture during percutaneous cardiac interventions. To study the clinical outcome of iASD after percutaneous left atrial appendage occlusion (LAAo). Single-center, retrospective study of 70 consecutive patients who underwent percutaneous LAAo between May 2010 and August 2017, and subsequent transesophageal echocardiography (TEE) at 1 month. Read More

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Transseptal Suturing With Turbinate Coblation in Nasal Septoturbinoplasty.

J Craniofac Surg 2021 Mar-Apr 01;32(2):734-737

Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan.

Objective: Transseptal suture-assisted septoplasty and coblation are two techniques that can effectively treat septal deviation and inferior turbinate hypertrophy without the need for post-operative packing. In the existing literature, however, the early post-operative symptoms and surgical outcomes of the combination of these 2 procedures have not been addressed.

Method: This retrospective study included 65 patients who underwent concomitant nasal septoturbinoplasty. Read More

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Transcatheter Mitral Valve Implantation Systematic Review: Focus on Transseptal Approach and Mitral Annulus Calcification.

Curr Cardiol Rep 2021 Mar 9;23(4):37. Epub 2021 Mar 9.

Service Médico-Chirurgical: Valvulopathies- Chirurgie Cardiaque - Cardiologie Interventionelle Structurelle, Hôpital Cardiologique de Haut Lévèque, CHU-Bordeaux, Bordeaux, France.

Introduction: This systematic review was performed to evaluate the results of transcatheter mitral valve implantation (TMVI) in the native mitral valve.

Evidence Acquisition: Medline, EMBASE, and the Cochrane Central register were systematically searched for studies that reported results of TMVI in mitral valve regurgitation and/or stenosis and mitral annular calcification. To improve the sensitivity of the literature search, we performed citation chasing in Google Scholar, Scopus, and Web of Science. Read More

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Left atrial appendage closure device implantation via transhepatic vascular access: a case report.

Eur Heart J Case Rep 2020 Dec 2;4(6):1-5. Epub 2020 Dec 2.

Aventura Hospital and Medical Center, Aventura, FL, USA.

Background: In patients with non-valvular atrial fibrillation, an estimated 90% of thrombi are located in the left atrial appendage. The WATCHMAN device is a left atrial appendage closure device that is an alternative therapeutic option to reduce the risk of systemic embolization in patients who are intolerant of long-term oral anticoagulation. It can be deployed in the left atrial appendage using a transseptal approach via the femoral vein. Read More

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December 2020

Utility of transesophageal echocardiography to assess real time left atrial pressure changes and dynamic mitral regurgitation following placement of transseptal multistage venous cannula for systemic venous drainage and indirect left ventricular venting in venoarterial extracorporeal membrane oxygenation.

Echocardiography 2021 Mar 22;38(3):493-499. Epub 2021 Feb 22.

Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.

A patient with heart failure due to nonischemic cardiomyopathy presented as a transfer to our institution following peripheral (femoral) venoarterial (VA) extracorporeal membrane oxygenation (ECMO) placement. With peripheral VA ECMO cannulation, the patient continued to have unstable ventricular tachyarrhythmias. Echocardiography demonstrated left ventricular (LV) dilation and severe mitral regurgitation (MR) with clinical and chest X-ray evidence of pulmonary edema. Read More

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Effectiveness and safety of single transseptal ablation for atrial fibrillation in real-word practice.

Clin Cardiol 2021 Apr 22;44(4):547-554. Epub 2021 Feb 22.

Department of Cardiology, Yonsei University Health System, Seoul, Republic of Korea.

Background: We have previously reported that unilateral groin-single transseptal (ST) ablation in patients with paroxysmal atrial fibrillation (AF) was safe and significantly reduced patient discomfort compared with bilateral groin-double transseptal (DT) ablation.

Hypothesis: In the present study, we hypothesized that ST ablation would be as effective and safe as DT ablation in real-world practice like previous study. Among the 1765 consecutive patients in the Yonsei AF ablation cohort from October 2015 to January 2020, 1144 patients who underwent radiofrequency ablation were included for the analysis. Read More

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A case report of pulmonary vein isolation with radiofrequency catheter using superior vena cava approach in patient with paroxysmal atrial fibrillation and inferior vena cava filter.

Eur Heart J Case Rep 2021 Feb 12;5(2):ytaa562. Epub 2021 Jan 12.

Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Yokohama 236-0004, Japan.

Background: Transseptal puncture and pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) are generally performed via the inferior vena cava (IVC). However, in cases where the IVC is inaccessible, a specific strategy may be needed.

Case Summary: An 86-year-old woman with paroxysmal AF and an IVC filter was referred to our hospital for ablation therapy. Read More

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February 2021

Transseptal mitral valve-in-valve implantation helps to elucidate the degree of concomitant aortic valve stenosis.

Postepy Kardiol Interwencyjnej 2020 Dec 29;16(4):516-518. Epub 2020 Dec 29.

Department of Cardiovascular Surgery, Hesperia Hospital, Modena, Italy.

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December 2020

Impact of the combined use of intracardiac ultrasound and a steerable sheath visualized by a 3D mapping system on pulmonary vein isolation.

Pacing Clin Electrophysiol 2021 Apr 11;44(4):693-702. Epub 2021 Mar 11.

Department of Medicine, Division of Cardiology, Nihon University School of Medicine, Tokyo, Japan.

Background: A novel steerable sheath visualized on a three-dimensional mapping system has become available in this era in which a durable pulmonary vein (PV) isolation (PVI) with reduced fluoroscopy is required.

Methods: In 60 patients who underwent a PVI with a visualized sheath (n = 30) and non-visualized conventional sheath (n = 30), the fluoroscopic time and catheter stability during the PVI were analyzed.

Results: The fluoroscopic time during the transseptal access (0 [0, 0. Read More

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A step-by-step guide to transseptal valve-in-valve transcatheter mitral valve replacement.

Ann Cardiothorac Surg 2021 Jan;10(1):113-121

Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

With the recent success of transcatheter aortic valve replacement (TAVR), transcatheter options for the management of mitral valve pathology have also gained considerable attention. Valve-in-valve (ViV) transcatheter mitral valve replacement (TMVR) is one such technique that has emerged as a safe and effective therapeutic option for patients with degenerated mitral valve bioprostheses at high-risk for repeat surgical mitral valve replacement. Several access strategies, including trans-apical, transseptal, trans-jugular, and trans-atrial access have been described for ViV-TMVR. Read More

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January 2021

Transcatheter mitral valve replacement: latest advances and future directions.

Ann Cardiothorac Surg 2021 Jan;10(1):85-95

Division of Cardiovascular Surgery, Department of Surgery, Hospital of the University of Pennsylvania & Penn Presbyterian Medical Center, Philadelphia, PA, USA.

Mitral regurgitation remains the most common form of valve disease worldwide and given an aging population with a significant proportion of secondary mitral regurgitation, a transcatheter approach to mitral valve replacement has become a major goal of the transcatheter therapeutics field. Mitral regurgitation can be caused by disease of the leaflets (primary) or by diseases of the left atrium or left ventricle (LV) (secondary or functional), and may involve overlap of the two (mixed disease). The location of the mitral valve (and large size), the approach to anchoring a valve replacement, and concerns about left ventricular outflow tract (LVOT) obstruction are all issues that have made the transcatheter delivery of a valve replacement challenging. Read More

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January 2021