Direct insertion of a floppy pigtail guidewire significantly reduced time to steerable guide catheter insertion compared to the traditional technique (17 vs 30 minutes; P=0.001).
Observational (n=39)
Does direct insertion of a floppy pigtail guidewire reduce time to steerable guide insertion compared to traditional stiff wire insertion in patients undergoing the MitraClip procedure?
Using a floppy pigtail guidewire for left atrial access during MitraClip procedures safely reduces the time required for steerable guide insertion compared to traditional stiff wire techniques.
Absolute Event Rate: 17% vs 30%
p-value: p=0.001
BACKGROUND: To assess whether a new floppy pigtail guidewire provides sufficient support for introduction of the 22F-steerable guide catheter (SG) into the left atrium and is less time-consuming during the MitraClip(®) -procedure without necessity of probing and inserting a stiff wire into the pulmonary vein. METHODS: In group 1, traditional probing of the left upper pulmonary vein and insertion of a standard stiff wire was used. In group 2, direct insertion of the floppy pigtail guidewire directly after transseptal puncture was used. RESULTS: Patients in group 1 (n = 18) and group 2 (n = 21) did not differ significantly with respect to mitral regurgitation severity (3.2 ± 0.4 vs 3.2 ± 0.4; P = 0.814) and etiology (functional 78% vs 71%, P = 0.651). Comparing both methods, a significant reduction in time-to-SG was observed in group 2 versus group 1 (17 ± 7 minutes vs 30 ± 11 minutes; P = 0.001). The rate of crossing failures was 0% with use of the floppy pigtail guidewire as well as with the traditional technique. No complications were observed with use of the floppy pigtail guidewire. CONCLUSIONS: Utilization of a thin, floppy pigtail guidewire for left atrium access is safe and markedly accelerates insertion of the SG for the MitraClip(®) -procedure without crossing failures of the atrial septum.
Büchner et al. (Tue,) conducted a observational in Mitral regurgitation (n=39). Direct insertion of a floppy pigtail guidewire vs. Traditional probing with a standard stiff wire was evaluated on Time to steerable guide catheter insertion (time-to-SG) (p=0.001). Direct insertion of a floppy pigtail guidewire significantly reduced time to steerable guide catheter insertion compared to the traditional technique (17 vs 30 minutes; P=0.001).