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

Martina Zucchetti, Michela Casella, Antonio Dello Russo, Gaetano Fassini, Corrado Carbucicchio, Eleonora Russo, Vittoria Marino, Valentina Catto, Claudio Tondo

Research output: Contribution to journalArticlepeer-review

Abstract

A 69-year-old man was admitted to our center to undergo catheter ablation of paroxysmal atrial fibrillation refractory to antiarrhythmic drug therapy. This procedure required access to the left atrium through the interatrial septum. During hospitalization, the patient performed routinely pre-procedure transthoracic echocardiography and gadolinium-enhanced cardiac magnetic resonance showing a normal anatomy of both the fossa ovalis and the interatrial septum. Access to the left atrium proved difficult and several unsuccessful attempts to perform the trans-septal puncture were made under both fluoroscopy and intracardiac echocardiography guidance, even with radiofrequency energy delivery. Finally, trans-septal puncture was successfully carried out using a novel nitinol J-shaped "SafeSept" trans-septal guidewire, designed to cross the interatrial septum through the trans-septal needle thanks to a special sharp tip. Moreover, thanks to its rounded J shape that reduces the risk of atrial perforation, the "SafeSept" guidewire, when advanced into the left atrium, becomes atraumatic.

Original languageEnglish
Pages (from-to)499-503
Number of pages5
JournalWorld Journal of Cardiology
Volume7
Issue number8
DOIs
Publication statusPublished - 2015

Keywords

  • "Safesept" guidewire
  • Atrial fibrillation
  • Interatrial septum
  • Intracardiac echocardiography
  • Trans-septal puncture

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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