Why the study?
When the inferior vena cava is unavailable due to congenital abnormalities or surgical ligation, an alternate route is needed to access the left atrium for transseptal catheter ablation or interventions.
Demonstrates the feasibility of direct hepatic vein puncture for transseptal access during atrial fibrillation and flutter ablation in a patient with an unavailable inferior vena cava.
May offer alternative access in rare IVC anomalies; hypothesis-generating case report requiring safety and reproducibility data.
The inferior vena cava (IVC) is commonly used in procedures involving left heart instrumentation, whereby catheters are introduced through the right or left femoral vein and advanced through the IVC towards the interatrial septum.1,2 Transseptal puncture then facilitates access into the left atrium for catheter ablation or other interventional procedures. When the IVC is not available, such as in cases with congenital abnormalities or surgical ligation of the IVC,3–5 an alternate route is required to access the left atrium.
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Suryanarayana et al. (2020) studied this question.
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