Aortic root perforation during left-sided accessory pathway ablation managed percutaneously with an multifunctional occluder device

Aortic root perforation is a rare but potentially catastrophic complication of transseptal puncture (TSP). We report the case of a 34-year-old male with Wolff-Parkinson-White syndrome who sustained inadvertent aortic root access during an electrophysiologic study and left-sided accessory pathway ablation. The complication led to tamponade and cardiac arrest but was successfully managed percutaneously using a KONAR-Multifunctional occluder device. The patient subsequently underwent successful ablation and had an uneventful recovery. This case highlights key steps for timely recognition, hemodynamic stabilization, and definitive percutaneous closure of aortic perforation. It also provides important technical and anatomical considerations for the safe performance of TSP in electrophysiology.