Right internal jugular vein transseptal puncture enabled successful left atrial access and ablation of left-sided accessory pathway in a patient with interrupted IVC.
A right internal jugular vein transseptal approach is a feasible and effective alternative for left atrial access during catheter ablation in patients with an interrupted inferior vena cava.
Absolute Event Rate: 0% vs 0%
Catheter ablation of left-sided accessory pathways typically requires femoral venous access with transseptal puncture; however, congenital interruption of the inferior vena cava (IVC) with azygos continuation makes this approach impractical. We report a 20-year-old man with Wolff���Parkinson���White syndrome in whom an interrupted IVC with azygos continuation was discovered during the procedure. After failed attempts using a retrograde aortic approach due to poor catheter stability, left atrial access was successfully achieved via a right internal jugular vein transseptal puncture guided by biplane fluoroscopy alone. A deflectable sheath provided stable mapping and enabled successful ablation of a left free-wall accessory pathway without complications. Postprocedural computed tomography confirmed the venous anomaly. This case highlights the right internal jugular vein transseptal approach as a feasible and effective alternative for left atrial access in patients with interrupted IVC when femoral access is not possible, provided the procedure is performed in experienced centers.
Ay et al. (Wed,) reported a other. Right internal jugular vein transseptal puncture enabled successful left atrial access and ablation of left-sided accessory pathway in a patient with interrupted IVC.