Septal branch in heart failure: Significant implications of an insignificant branch

Septal branch in percutaneous coronary intervention: A strange and rare brew. Author’s reply

“…We wish to express our gratitude to Yalta et al [1] for showing interest in our case report depicting important consequences of septal branch (SB) occlusion during percutaneous coronary intervention (PCI) on the left anterior descending (LAD) coronary artery [2]. As Yalta et al remarked, several conduction abnormalities can ensue following SB occlusion.…”

The first septal perforating artery in the setting of percutaneous coronary interventions: More than just a side branch

“…In patients undergoing percutaneous coronary interventions (PCIs), occlusion of small side branches, including the first septal perforating artery (SPA), has been generally ignored by performing operators [1]. However, the first SPA might have a pivotal role in the perfusion of critical areas of the cardiac conduction system with important implications [1][2][3].…”

“…In patients undergoing percutaneous coronary interventions (PCIs), occlusion of small side branches, including the first septal perforating artery (SPA), has been generally ignored by performing operators [1]. However, the first SPA might have a pivotal role in the perfusion of critical areas of the cardiac conduction system with important implications [1][2][3]. The recent article by Pavlov et al [1] has reported a case of heart failure complicated by the occlusion of the first SPA and consequent atrioventricular (AV) block during PCI and has also described the management strategy of this challenging case [1].…”

“…However, the first SPA might have a pivotal role in the perfusion of critical areas of the cardiac conduction system with important implications [1][2][3]. The recent article by Pavlov et al [1] has reported a case of heart failure complicated by the occlusion of the first SPA and consequent atrioventricular (AV) block during PCI and has also described the management strategy of this challenging case [1]. Accordingly, we would like to comment on clinical and practical implications regarding the acute occlusion of the first SPA during PCI.…”

“…The patient had a transient AV block possibly due to acute intra-Hisian or infra-Hisian ischemia (possibly due to a co-existing new-onset RBBB and LBBB) [1]. Patients with this kind of AV block are well known to present with wide QRS morphology, along with severe bradycardia and hemodynamic compromise due to the ventricular origin of the escape rhythm [2].…”