Approach to the Difficult Transseptal: Diathermy Facilitated Left Atrial Access

作者：Abed Hany S; A****dy Muayad; Lau Dennis H; Lim Han S; Sanders Prashanthan^*

来源：Heart Lung and Circulation, 2012, 21(2): 108-112.

DOI：10.1016/j.hlc.2011.07.010

• Transseptal puncture
• Radiofrequency
• Left atrial access
• Body surface area

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. (Heart, Lung and Circulation 2012;21:108-112) Crown Copyright (C) 2011 Published by Elsevier Inc. on behalf of Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).

• 出版日期2012-2