806 results match your criteria transseptal puncture


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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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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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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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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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 Puncture Learning Curve for Transcatheter Edge-to-Edge Mitral Valve Repair.

Innovations (Phila) 2021 Feb 11:1556984521992403. Epub 2021 Feb 11.

12264 Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.

Objective: This study examined the learning curve for transseptal puncture (TSP) during transcatheter edge-to-edge mitral valve repair (TEER) performed by a dedicated mitral valve structural heart team. Effective TSP is mandatory for TEER but can be time-consuming and associated with complications including pericardial effusion and cardiac tamponade.

Methods: TSP was performed on 107 consecutive patients (76 ± 1 years, 52% male) undergoing TEER between 2014 and 2019. Read More

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February 2021

One-year results of the first-in-man study investigating the Atrial Flow Regulator for left atrial shunting in symptomatic heart failure patients: the PRELIEVE study.

Eur J Heart Fail 2021 Feb 8. Epub 2021 Feb 8.

Department of Internal Medicine, Cardiology, Angiology and Intensive Care Medicine, University Clinic Saarland, Homburg, Germany.

Aims: Attenuating exercise-induced elevated left atrial pressure with an atrial shunt device is under clinical investigation for treatment of symptomatic heart failure (HF).

Methods And Results: PRELIEVE was a prospective, non-randomised, multicentre, first-in-man study in symptomatic HF patients with reduced (HFrEF) or preserved (HFpEF) ejection fraction and pulmonary capillary wedge pressure (PCWP) ≥15 mmHg at rest or ≥25 mmHg during exercise. Here, we provide follow-up data up to 1 year after implantation of the Atrial Flow Regulator (AFR) device. Read More

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February 2021

Modified wire atrial septostomy with a reverse transseptal puncture in an infant: Case report.

Catheter Cardiovasc Interv 2021 Apr 4;97(5):865-868. Epub 2021 Feb 4.

Department of Pediatrics, Graduate School of Medical Science, Kyushu University Hospital, Fukuoka, Japan.

We report a modified technique of wire atrial septostomy (WAS) with a reverse transseptal puncture (TSP) in an infant case of pulmonary atresia with intact ventricular septum. A radiofrequency (RF) wire was advanced to the septum through a 4 Fr pigtail catheter hooked on the left side of atrial septum and RF energy was applied while advancing the wire across the septum. Following that reverse TSP, WAS was performed to cut the septal tissue using a 0. Read More

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Application of cardiac computed tomographic imaging and fluoroscopy fusion for guiding left atrial appendage occlusion.

Int J Cardiol 2021 May 30;331:289-295. Epub 2021 Jan 30.

Department of Cardiovascular, Chinese PLA General Hospital, Beijing 100853, China.

Objective: Evaluate the value of 3D computed tomography (CT) and CT-integrating fluoroscopy for procedural guidance during WATCHMAN implantation.

Methods: This observational study compared the clinical and procedural parameters for LAAO with and without fusion imaging. Forty-one pairs of patients-matched by procedure month and with or without the use of the image fusion system-were enrolled. Read More

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Case report: Concomitant MitraClip implantation for severe mitral regurgitation and plug closure of endocarditis induced fistula between aortic root and left atrium after transcatheter aortic valve implantation.

Eur Heart J Case Rep 2021 Jan 21;5(1):ytaa573. Epub 2021 Jan 21.

Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.

Background: Infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) occurs in up to 1.5% of patients within the first year. The development of an aorto-atrial fistula (AAF) is a rare but problematic complication of IE, which can be confirmed with transoesophageal echocardiography (TOE). Read More

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January 2021

VersaCross radiofrequency system reduces time to left atrial access versus conventional mechanical needle.

J Interv Card Electrophysiol 2021 Jan 22. Epub 2021 Jan 22.

Division of Cardiology, Vancouver General Hospital, University of British Columbia, 2775 Laurel Street, Level 9, Vancouver, BC, V5Z1M9, Canada.

Background: Despite maturing experience, transseptal puncture (TSP) remains a challenging part of percutaneous left atrial appendage closure (LAAC) and has inherent risks and safety concerns in accessing the left atrium (LA). The VersaCross radiofrequency (RF) system (Baylis Medical), a new RF-tipped pigtail wire-based TSP system, may facilitate LA access by serving as an exchange support wire once access is achieved.

Methods: We retrospectively compared TSP safety and procedural efficiency in 10 consecutive LAAC cases using the VersaCross RF system to 10 cases using the conventional BRK1-XS mechanical needle (Abbott Vascular). Read More

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January 2021

A simple improvement on existing technology to enhance transseptal puncture and left atrial access using large diameter sheaths for mapping, ablation, and LAA occlusion procedures.

J Cardiovasc Electrophysiol 2021 Mar 2;32(3):735-736. Epub 2021 Feb 2.

Division of Cardiology, Department of Medicine, University of California San Diego Health System, California, USA.

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A new transseptal solution for enabling left atrial access of large delivery sheaths.

J Cardiovasc Electrophysiol 2021 Mar 2;32(3):729-734. Epub 2021 Feb 2.

Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.

Background: Transseptal access for large sheaths may be encumbered by tissue resistance against the sheath-dilator stepped interface. The ExpanSure Large Access Transseptal Dilator (Baylis Medical) is designed as a single introducer and dilation device with a smooth sheath-dilator transition to support transseptal puncture. It may facilitate ease and efficiency of interatrial crossing. Read More

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Safety of Transseptal Puncture for Access to the Left Atrium in Infants and Children.

Pediatr Cardiol 2021 Mar 16;42(3):685-691. Epub 2021 Jan 16.

Department of Pediatric Cardiology and Intensive Care Medicine, Georg August University Medical Center, Robert-Koch-Str. 40, 37075, Göttingen, Germany.

Transseptal puncture (TSP) is a standard procedure to obtain access to the left heart. However, data on TSP in infants and children particularly with congenital heart defects (CHD) is sparse. Safety and efficacy of TSP in infants and children < 18 years with normal cardiac anatomy and with CHD were assessed. Read More

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Multimodality imaging anatomy of interatrial septum and mitral annulus.

Heart 2020 Dec 22. Epub 2020 Dec 22.

National Heart and Lung Institute, London, UK.

The detailed anatomy of the interatrial septum (IAS) and mitral annulus (MA) as observed on cardiac magnetic resonance, computed tomography and two-dimensional/three-dimensional transthoracic and transesophageal echocardiography is reviewed. The IAS comprises of two components: the septum primum that is membrane-like forming the floor of the fossa ovalis (FO) and the septum secundum that is a muscular rim that surrounds the FO. The latter is an enfolding of atrial wall forming an interatrial groove. Read More

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December 2020

Case report: Buddy wire technique to facilitate atrial septal crossing during transcatheter transseptal mitral valve implantation.

Eur Heart J Case Rep 2020 Dec 9;4(6):1-4. Epub 2020 Nov 9.

Division of Cardiology, Rush University Medical Center, 1717 W Congress parkway, Suite 313, 3-Kellogg, Chicago, IL, USA.

Background: Transcatheter mitral valve-in-valve implantation (MVIV) has emerged as a viable treatment option in patients at high risk for surgery. Occasionally, despite appropriate puncture location and adequate dilation, difficulty is encountered in advancing the transcatheter heart valve across interatrial septum.

Case Summary: We describe a case of a 79-year-old woman with severe chronic obstructive pulmonary disease (COPD), prior surgical bioprosthetic aortic and mitral valve replacement implanted in 2007, atrial fibrillation, and Group II pulmonary hypertension who presented with progressively worsening heart failure symptoms secondary to severe bioprosthetic mitral valve stenosis and moderate-severe mitral regurgitation. Read More

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December 2020

Real-time echocardiography-fluoroscopy fusion imaging for left atrial appendage closure: prime time for fusion imaging?

Acta Cardiol 2021 Jan 13:1-9. Epub 2021 Jan 13.

Division of Cardiology, Pulmonology and Vascular Medicine, University Medical Center Düsseldorf, Düsseldorf, Germany.

Background: Real-time echocardiography-fluoroscopy fusion imaging (FI) merges real-time echocardiographic imaging with fluoroscopic images allowing intuitive anatomical spatial orientation during structural heart disease interventions. We aimed to assess the safety and efficacy of FI during percutaneous left atrial appendage closure (LAAC)

Methods: 34 consecutive patients before (-FI) and 121 patients after (+FI) the introduction of FI for LAAC were included in a single-centre study. In-hospital safety parameters were analysed according to adverse event (AE) definition of the Munich consensus document and procedure-related parameters were assessed for efficacy. Read More

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January 2021

Catheter ablation of atrial fibrillation in situs inversus dextrocardia: Challenge, improved procedure, outcomes, and literature review.

Pacing Clin Electrophysiol 2021 Feb 5;44(2):293-305. Epub 2021 Jan 5.

Department of Cardiology, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Chaoyang District, Beijing, China.

Introduction: Catheter ablation for atrial fibrillation (AF-CA) in patients with situs inversus dextrocardia (SID) can be challenging because of the contrary anatomy and associated anomalies. Cases and literature regarding AF-CA in SID are rare and provide little information. Our study aims to present an improved procedure, ablation strategies, and evaluate the safety and outcomes of AF-CA in patients with AF and SID. Read More

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February 2021

Right atrial-related structures in horses of interest during electrophysiological studies.

Equine Vet J 2020 Dec 25. Epub 2020 Dec 25.

Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Background: Arrhythmias are common in horses, but catheter-based minimally invasive electrophysiological studies and therapeutic interventions have been poorly explored in equine medicine, partly due to the lack of detailed anatomical knowledge of the equine heart.

Objectives: To describe the dimensions and anatomical features of some electrophysiologically important landmarks of the right atrium in detail and assess their correlation with bodyweight and aortic diameter.

Study Design: Ex vivo cadaveric study. Read More

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December 2020

Trans-coronary sinus puncture for catheter ablation and left atrial appendage closure device implantation in a patient with dextrocardia and persistent right superior vena cava.

HeartRhythm Case Rep 2020 Dec 25;6(12):903-906. Epub 2020 Aug 25.

Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas.

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December 2020

Zero-fluoroscopy catheter ablation for atrial fibrillation: a transitional period experience.

J Arrhythm 2020 Dec 30;36(6):1061-1067. Epub 2020 Oct 30.

Departments of Internal Medicine Seoul National University Hospital Seoul South Korea.

Background: Radiofrequency catheter ablation for atrial fibrillation (AF) without using fluoroscopy has been getting popular. In this study, we reported the transition period experience of the zero-fluoroscopy procedure by an experienced operator and shared our zero-fluoroscopy protocol.

Method: A total of consecutive 30 AF ablation cases attempted to be treated without fluoroscopy were investigated. Read More

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December 2020

Extraluminal recanalization for postoperative biliary obstruction using transseptal needle.

Surg Case Rep 2020 Dec 3;6(1):304. Epub 2020 Dec 3.

Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Japan.

Background: Postoperative biliary strictures are commonly related to accidental bile duct injuries or occur at the site of biliary anastomosis. The first-line treatment for benign biliary strictures is endoscopic therapy, which is less invasive and repeatable. However, recanalization for biliary complete obstruction is technically challenging to treat. Read More

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December 2020

4D Intracardiac Echocardiography-Guided LA Appendage Closure Under Conscious Sedation: Initial Experience and Procedural Technique.

JACC Cardiovasc Imaging 2020 Nov 18. Epub 2020 Nov 18.

Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota; University of Minnesota, Minneapolis, Minnesota.

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November 2020

Imaging the Fossa Ovalis With Electroanatomical Voltage Mapping.

JACC Clin Electrophysiol 2020 11;6(12):1599-1601

Sutter Heart and Vascular Institute, Sacramento, California, USA. Electronic address:

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November 2020

Transseptal puncture for ablation of atrial fibrillation in a patient with an implanted atrial flow regulator: a case report.

Eur Heart J Case Rep 2020 Oct 25;4(5):1-4. Epub 2020 Aug 25.

Department of Electrophysiology, University Heart Center Cologne, Kerpener Str. 62, 50937 Cologne, Germany.

Background: Atrial flow regulator (AFR) (Occlutech, Helsingborg, Sweden) are self-expanding, circular devices. A flexible waist in the centre connects the two discs and has a centrally located shunt.

Case Summary: We report a case of an 80-year-old woman undergoing a repeat left atrial ablation for persistent atrial fibrillation with an implanted AFR. Read More

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October 2020

Initial clinical experience with VersaCross transseptal system for transcatheter mitral valve repair.

Catheter Cardiovasc Interv 2020 Nov 11. Epub 2020 Nov 11.

Department of Cardiology, Montreal Heart Institute, Montreal, Quebec City, Canada.

Objectives: The aim of this study is to describe the initial experience with versacross transseptal (TS) system for transseptal puncture for the transcatheter mitral valve repair using the MitraClip device.

Background: Transeptal puncture is a key step in transcatheter mitral valve repair (MVR) and the use of the VersaCross system comprised of a sheath, a dilator and a radiofrequency wire has not been previously described.

Methods: Prospective single center study of consecutive patients undergoing transcatheter mitral valve repair with the MitraClip device were included. Read More

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November 2020

Iatrogenic Atrial Septal Defect After Percutaneous Mitral Valve Repair With MitraClip: Should We Consider Closing Them Routinely?

J Invasive Cardiol 2020 Nov;32(11):E295-E297

La Paz University Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain.

Percutaneous MitraClip intervention for treatment of severe mitral regurgitation in high surgical risk patients requires large-diameter transseptal sheaths that can result in iatrogenic atrial septal defect (iASD), and its prevalence is higher compared with non-MitraClip procedures. This iASD is not routinely closed because the possible consequences are still not fully understood. However, we believe it is important to identify patients who may benefit from its closure immediately after the procedure to prevent hemodynamic deterioration and long-term negative clinical outcomes. Read More

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November 2020

Catheter ablation of complex atrial tachyarrhythmias in adult patients with cor triatriatum.

J Interv Card Electrophysiol 2020 Oct 19. Epub 2020 Oct 19.

Heart Rhythm Center and Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, 11217, Taiwan.

Purpose: Reports concerning clinical characteristics of cor triatriatum and approaches for catheter ablation of complex atrial tachyarrhythmias remain limited. Here, we describe successful catheter ablation treatments for complex atrial tachyarrhythmias in patients with cor triatriatum and address the clinical caveats.

Methods: Demographic characteristics, electrophysiologic findings, and ablation results in four patients with cor triatriatum were described. Read More

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October 2020