Why the study?
Coronary artery spasm or transient ST-segment elevation during transseptal catheterization has been previously reported as mostly reversible or asymptomatic.
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Mechanical tension on the interatrial vagal network during transseptal puncture preparation can trigger fatal coronary artery spasm and arrhythmias.
Background: Transient ST-segment elevation or coronary artery spasm during transseptal catheterization has been previously described. Most cases were either reversible or asymptomatic. Case summary: We present a case of severe multiple coronary artery spasms with advanced atrioventricular block and ventricular fibrillation during compression of the fossa ovalis by a sheath catheter, before the performance of the transseptal puncture procedure for mitral transcatheter edge-to-edge-repair. Discussion: The mechanical effects of forward tension from transseptal puncture on the interatrial vagal network could be the most possible explanation for the occurrence of this phenomenon.
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Mo et al. (2022) studied this question.
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