TY - JOUR
T1 - Approach to the difficult transseptal
T2 - Diathermy facilitated left atrial access
AU - Abed, Hany S.
AU - Alasady, Muayad
AU - Lau, Dennis H.
AU - Lim, Han S.
AU - Sanders, Prashanthan
N1 - Funding Information:
Dr. Sanders reports having served on the advisory board of, and has received lecture fees and research funding from, Bard Electrophysiology, Biosense-Webster, Medtronic and St. Jude Medical.
Funding Information:
Drs. Abed, Alasady and Lim are supported by Earl Bakken Scholarships from the University of Adelaide. Drs. Lau and Lim are supported by a Postgraduate Medical Scholarship from the National Health and Medical Research Council of Australia. Dr. Sanders is supported by the National Heart Foundation of Australia.
PY - 2012/2
Y1 - 2012/2
N2 - Percutaneous transseptal left atrial (LA) access is increasingly becoming a routine procedure in the electrophysiology and cardiac catheterisation laboratories. Our aim was to review an unselected large series of this procedure performed over a period of five years. We clinically characterised difficult cases and presented a method of safe and expeditious LA access. Overall, 543 transseptal punctures were performed. Of those, 10 were classified as difficult, with failure to access the LA in three or more attempts. In all 10 cases, surgical electrocautery was successfully used to facilitate needle puncture of the septum. All patients subsequently underwent an uncomplicated procedure. In conclusion, we describe a method to trouble-shoot the difficult transseptal access procedure, outlining the clinical characteristics, echocardiographic features and special precautions that need to be considered when utilising this method.
AB - Percutaneous transseptal left atrial (LA) access is increasingly becoming a routine procedure in the electrophysiology and cardiac catheterisation laboratories. Our aim was to review an unselected large series of this procedure performed over a period of five years. We clinically characterised difficult cases and presented a method of safe and expeditious LA access. Overall, 543 transseptal punctures were performed. Of those, 10 were classified as difficult, with failure to access the LA in three or more attempts. In all 10 cases, surgical electrocautery was successfully used to facilitate needle puncture of the septum. All patients subsequently underwent an uncomplicated procedure. In conclusion, we describe a method to trouble-shoot the difficult transseptal access procedure, outlining the clinical characteristics, echocardiographic features and special precautions that need to be considered when utilising this method.
KW - Body surface area
KW - Left atrial access
KW - Radiofrequency
KW - Transseptal puncture
UR - https://www.scopus.com/pages/publications/84856343882
U2 - 10.1016/j.hlc.2011.07.010
DO - 10.1016/j.hlc.2011.07.010
M3 - Article
C2 - 21900045
AN - SCOPUS:84856343882
SN - 1443-9506
VL - 21
SP - 108
EP - 112
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
IS - 2
ER -