Document Detail


Nonfluoroscopic transseptal catheterization: safety and efficacy of intracardiac echocardiographic guidance.
MedLine Citation:
PMID:  9654229     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Recently, there has been a revival in the use of transseptal catheterization due to the development of balloon mitral valvuloplasty and radiofrequency catheter ablation. Complications of transseptal puncture, although rare, can be serious and life-threatening. In the present study, we evaluated the use of intracardiac echocardiography (ICE) as the sole imaging modality to guide transseptal puncture and catheterization. METHODS AND RESULTS: In each animal, 10 transseptal punctures were performed guided solely by ICE. The standard approach to transseptal catheterization using a Brockenbrough needle and long vascular sheath was used except for the use of ICE instead of fluoroscopy. A 6.2-French/12.5-MHz and 9-French/9-MHz ICE catheter was used for imaging. At the end of each study, pathologic evaluation was performed. Transseptal puncture was performed safely, guided solely by ICE, in each of 100 attempts (five attempts guided by each ICE catheter in 10 dogs). While the fossa ovalis was easily visualized with both ICE catheters, the 9-French/9-MHz catheter offered an enhanced field of view. On pathologic evaluation, there was no evidence of perforation of either the right or left atrium outside of the fossa ovalis. CONCLUSION: Both ICE catheters used in this trial allowed for excellent visualization of the fossa ovalis and safe transseptal puncture. Intracardiac echocardiography may be a better imaging modality than fluoroscopy for guiding transseptal catheterization, especially in less experienced hands.
Authors:
L M Epstein; T Smith; H TenHoff
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  9     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-09-18     Completed Date:  1998-09-18     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  625-30     Citation Subset:  IM    
Affiliation:
Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA. lepstein@bidmc.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Dogs
Echocardiography*
Fluoroscopy
Heart Catheterization / methods*
Heart Septum / surgery*
Punctures*
Safety

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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