Fossa Ovalis Radiofrequency Perforation in a Difficult Case of Conventional Transseptal Puncture for Atrial Fibrillation Ablation

Overview

Journal J Interv Card Electrophysiol

Publisher Springer

Date 2008 Feb 16

PMID 18274714

Citations 4

Authors

Michela Casella

Antonio Dello Russo

Gemma Pelargonio

Annamaria Martino

Stefano De Paulis

Paolo Zecchi

Fulvio Bellocci

Claudio Tondo

Affiliations

Soon will be listed here.

Abstract

A 65-year-old man was referred for atrial fibrillation ablation to our center. Routine pre-procedure transthoracic and transoesophageal echocardiography and cardiac computed tomography examinations showed a normal interatrial septum and fossa ovalis anatomy. Access to left atrium was initially planned using a conventional transseptal needle puncture. During the procedure, several consecutive attempts in conjunction with intracardiac echocardiography support, failed to cross the septum. The procedure was then successfully carried out using a specifically designed radiofrequency transseptal catheter.

Citing Articles

Role of Intracardiac echocardiography in Atrial Fibrillation Ablation.

Dello Russo A, Russo E, Fassini G, Casella M, Innocenti E, Zucchetti M J Atr Fibrillation. 2017; 5(6):786.

PMID: 28496830 PMC: 5153176. DOI: 10.4022/jafib.786.

Difficult case of a trans-septal puncture: Use of a "SafeSept" guidewire.

Zucchetti M, Casella M, DelloRusso A, Fassini G, Carbucicchio C, Russo E World J Cardiol. 2015; 7(8):499-503.

PMID: 26322190 PMC: 4549784. DOI: 10.4330/wjc.v7.i8.499.

Prospective comparison between conventional transseptal puncture and transseptal needle puncture with radiofrequency energy.

Fromentin S, Sarrazin J, Champagne J, Nault I, Philippon F, Molin F J Interv Card Electrophysiol. 2011; 31(3):237-42.

PMID: 21503731 DOI: 10.1007/s10840-011-9564-2.

Use of a novel needle wire in patients undergoing transseptal puncture associated with severe septal tenting.

Wieczorek M, Hoeltgen R, Akin E, Salili A J Interv Card Electrophysiol. 2010; 27(1):9-13.

PMID: 20072804 DOI: 10.1007/s10840-009-9460-1.

References

Fagundes R, Mantica M, De Luca L, Forleo G, Pappalardo A, Avella A . Safety of single transseptal puncture for ablation of atrial fibrillation: retrospective study from a large cohort of patients. J Cardiovasc Electrophysiol. 2007; 18(12):1277-81. DOI: 10.1111/j.1540-8167.2007.00958.x. View

Daoud E, Kalbfleisch S, Hummel J . Intracardiac echocardiography to guide transseptal left heart catheterization for radiofrequency catheter ablation. J Cardiovasc Electrophysiol. 1999; 10(3):358-63. DOI: 10.1111/j.1540-8167.1999.tb00683.x. View

Veldtman G, Wilson G, Peirone A, Hartley A, Estrada M, Norgard G . Radiofrequency perforation and conventional needle percutaneous transseptal left heart access: pathological features. Catheter Cardiovasc Interv. 2005; 65(4):556-63. DOI: 10.1002/ccd.20328. View

Cheng A, Calkins H . A conservative approach to performing transseptal punctures without the use of intracardiac echocardiography: stepwise approach with real-time video clips. J Cardiovasc Electrophysiol. 2007; 18(6):686-9. DOI: 10.1111/j.1540-8167.2006.00716.x. View

ROSS Jr J . Catheterization of the left heart through the interatrial septum: a new technique and its experimental evaluation. Surg Forum. 1958; 9:297-300. View