The use of balloon atrial septostomy to facilitate difficult transseptal access in patients undergoing catheter ablation for atrial fibrillation
| Autor: | David S. Cannom, Ivan C. Ho, Bruce L. Macrum, Andrew A. Zadeh |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Perforation (oil well) Catheter ablation Transesophageal echocardiogram Balloon Physiology (medical) Angioplasty Internal medicine Atrial Fibrillation medicine Humans Balloon septostomy Atrial septostomy Angioplasty Balloon Coronary medicine.diagnostic_test Atrial Septum business.industry Middle Aged Surgery medicine.anatomical_structure Cardiology Catheter Ablation Cardiology and Cardiovascular Medicine business Interatrial septum |
| Zdroj: | Journal of cardiovascular electrophysiology. 22(7) |
| ISSN: | 1540-8167 |
| Popis: | Use of Balloon Atrial Septostomy. Introduction: With the increasing number of patients undergoing repeat catheter ablation procedures for atrial fibrillation, it is not uncommon to encounter a fibrotic interatrial septum that resists the conventional manual advancement of the transseptal sheath. Forceful advancement of the transseptal apparatus can reduce fine control and potentially lead to a higher rate of perforation. Case: We report a case where adjunctive balloon atrial septostomy was used to facilitate transseptal access in a patient with fibrotic interatrial septum. Using a small-caliber angioplasty balloon and under direct fluoroscopic and transesophageal echocardiogram visualization, balloon septostomy was performed with hand inflation until a “waist” was seen. This technique provides a safe way to control the size of the transseptal access created, and allows the passage of a relatively soft-tipped transseptal sheath across a resistive septum. To our knowledge this is the first published use of balloon atrial septostomy during transseptal puncture for left atrium access in a catheter ablation procedure. Conclusion: Balloon atrial septostomy should be considered as an alternative technique for safe transseptal cannulation in select patients in the electrophysiology laboratory or other interventional procedures requiring left atrial access or delivery of large-caliber catheters or sheaths. (J Cardiovasc Electrophysiol, Vol. 22, pp. 822-824, July 2011) |
| Databáze: | OpenAIRE |
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