Preventing complicated transseptal puncture with intracardiac echocardiography: case report

Shalganov, Tchavdar; Paprika, Dóra; Borbás, Sarolta; Temesvári, A; Szili-Török, Tamás

doi:10.1186/1476-7120-3-5

Cited by 19 publications

(13 citation statements)

References 8 publications

(7 reference statements)

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“…Thereafter further steps remain the same. Transesophageal and intracardiac echo may be important adjunctive sometimes but also cumbersome otherwise [9]. The trans-jugular approach is thought to overcome many of the technical problems encountered with the transfemoral route in cases with anatomical alterations [10].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Mitral Valvotomy in a Case of Situs Inversus Totalis and Juvenile Rheumatic Critical Mitral Stenosis: Case Report

et al. 2016

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Situs inversus totalis is a rare congenital disorder where the heart being a mirror image is situated on the right side of the body. Distorted cardiac anatomy makes fluoroscopy-guided percutaneous mitral valvotomy (PMV) technically challenging and there are only few reports of PMV in situs inversus totalis. Here we report a case where PMV was successfully done for situs inversus totalis with rare coincidence of juvenile rheumatic severe mitral stenosis in a 12-year-old boy with a few modifications of standard Inoue technique. He had exertional dyspnea of NYHA class III with initial mitral valve area (MVA) of 0.6 cm2 and severe pulmonary arterial hypertension with features suitable for PMV. Femoral vein was accessed from the left side to align the septal puncture needle and balloon to facilitate left ventricular entry. Septal descent and puncture by Brockenbrough needle was performed in the right anterior oblique view with the needle facing 5 o’clock position. Accura balloon was negotiated across mitral valve in left anterior oblique and procedure was successfully executed. Echocardiography showed a well-divided anterior commissure with an MVA of 2.0 cm2 and mild mitral regurgitation. In summary, PMV is safe and feasible in the rare patient with situs inversus totalis with few modifications of the Inoue technique.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Mitral Valvotomy in a Case of Situs Inversus Totalis and Juvenile Rheumatic Critical Mitral Stenosis: Case Report

et al. 2016

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“…Apart from thrombus exclusion, the strategy at our institution to perform TEE in every patient helped to detect structural abnormalities of the IAS in nearly half of the patients. Detailed knowledge about the IAS with a variety of morphologic abnormalities facilitates the optimal and riskless performance of a single or double transseptal puncture using long sheaths . López‐Candales et al .…”

Section: Discussionmentioning

confidence: 99%

High Incidence of Echocardiographic Abnormalities of the Interatrial Septum in Patients Undergoing Ablation for Atrial Fibrillation

et al. 2012

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A structurally abnormal IAS was diagnosed in nearly half of the patients undergoing ablation therapy for AF. The information obtained by TEE is mandatory to exclude left atrial thrombi prior the ablation procedure. Moreover, detailed knowledge of morphologic characteristics of the IAS facilitates an optimized and safe performance of the transseptal puncture using long sheaths with large diameters.

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“…3A) of the fossa ovalis (the thin septum) by the TS catheter tip indicates correct positioning, even if the needle or catheter cannot be visualized. Newer imaging modalities such as intracardiac echocardiography (AcuNav ICE, Siemens Medical Systems, Mountain View, California) (12,14,15) have also been used with success. The role of 3-dimensional TEE has yet to be fully evaluated, although initial experience is positive (Fig.…”

Section: Localization Of the Fossa Ovalismentioning

confidence: 99%

Emerging Applications for Transseptal Left Heart Catheterization

Babaliaros

Green

Lerakis

et al. 2008

Journal of the American College of Cardiology

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Transseptal (TS) catheterization was introduced in 1959 as a strategy to directly measure left atrial (LA) pressure. Despite acceptable feasibility and safety, TS catheterization has been replaced by indirect measurements of LA pressure using the Swan-Ganz catheter. Today, TS puncture is rarely performed for diagnostic purposes but continues to be performed for procedures such as balloon mitral valvuloplasty, antegrade balloon aortic valvuloplasty, and ablation of arrhythmias in the LA. Thus, the "art" of TS puncture has been lost, except in centers that perform these procedures with regularity. Recently, there has been a renewed interest in the TS technique because of emerging therapeutic procedures for structural heart disease and atrial fibrillation ablation. Invasive cardiologists will have to refamiliarize themselves with the TS technique, newer TS devices, and advanced ultrasound imaging for guidance of the procedure.

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Preventing complicated transseptal puncture with intracardiac echocardiography: case report

Cited by 19 publications

References 8 publications

Percutaneous Mitral Valvotomy in a Case of Situs Inversus Totalis and Juvenile Rheumatic Critical Mitral Stenosis: Case Report

Percutaneous Mitral Valvotomy in a Case of Situs Inversus Totalis and Juvenile Rheumatic Critical Mitral Stenosis: Case Report

High Incidence of Echocardiographic Abnormalities of the Interatrial Septum in Patients Undergoing Ablation for Atrial Fibrillation

Emerging Applications for Transseptal Left Heart Catheterization

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