Key result
Attempted transseptal puncture in a patient with lipomatous hypertrophy of the interatrial septum resulted in a rare complication of interatrial septal dissection without pericardial penetration.
Why the study?
Dissection of the interatrial septum is a rare complication of transseptal puncture reported in less than 1% of procedures.
Case Report (n=1)
No
Lipomatous hypertrophy of the interatrial septum can increase the risk of septal dissection during transseptal puncture, highlighting the importance of pre-procedural and intra-procedural imaging like intracardiac echocardiography.
Answers are grounded in this paper and cite their sources.
Alerts to dissection risk in lipomatous hypertrophy; leaves open optimal imaging strategies to mitigate it.
Transseptal puncture is a standard procedure to access the left atrium during catheter ablation of arrhythmias. It is associated with high success and a meager complication rate in the contemporary era. The potential complications of transseptal puncture include aortic puncture, perforation of the right/left atrial free wall resulting in pericardial effusion/tamponade, and systemic thromboembolism. The dissection of the interatrial septum (IAS) is a rare complication of transseptal puncture, reported in less than 1% of the procedures. We report a case of a dissection of the IAS during an attempted transseptal puncture in a 72-year-old man with lipomatous hypertrophy of the interatrial septum.
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Ahmed et al. (2022) conducted a case report in Paroxysmal atrial fibrillation and lipomatous hypertrophy of the interatrial septum (n=1). Transseptal puncture was evaluated on Complication (dissection of the interatrial septum). Attempted transseptal puncture in a patient with lipomatous hypertrophy of the interatrial septum resulted in a rare complication of interatrial septal dissection without pericardial penetration.
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