An angioplasty wire can be used to successfully facilitate transseptal puncture in cases where conventional needle approaches fail due to complex anatomy.
May serve as bailout in failed conventional transseptal puncture; hypothesis-generating case report that leaves open safety and reproducibility.
With the expansion in catheter-based treatments for atrial fibrillation the number of transseptal punctures being performed by cardiac electrophysiologists has increased significantly. Although in general transseptal puncture is successful, in a small percentage of cases it cannot be achieved due to complex intraatrial anatomy. We report the case of a difficult transseptal puncture (TSP), performed where the conventional approach using a Brockenbrough needle sheath was unable to perforate the septum. TSP was only achieved using a novel technique assisted by an angioplasty wire.
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Ahsan et al. (2009) studied this question.
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