What question did this study set out to answer?

To assess the safety, technical efficacy, and risk of residual shunting associated with performing transseptal puncture through intra-atrial patches, baffles, and conduits.

January 1, 2000Catheterization and Cardiovascular Interventions

18-year experience with transseptal procedures through baffles, conduits, and other intra-atrial patches

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Why the study?

Is transseptal puncture through an intra-atrial patch safe and effective for left heart access in pediatric patients with repaired congenital heart disease?

Key Points

To assess the safety, technical efficacy, and risk of residual shunting associated with performing transseptal puncture through intra-atrial patches, baffles, and conduits.
Retrospective review of patients with intra-atrial patches undergoing transseptal puncture between November 1979 and February 1998 (N=39 out of 1,958 total transseptal procedures; median age 7 years, range 1–31).
Analyzed underlying congenital diagnoses, surgical repairs (Mustard, Senning, Fontan, total anomalous venous return, atrioventricular canal, and atrial septal defect patches), procedural success, and post-procedure echocardiograms.
The intra-atrial patch was successfully traversed in 97.5% of cases (38/39 patients) to perform diagnostic or therapeutic left-heart catheterization, with zero procedural complications.
Follow-up echocardiograms in 30 patients demonstrated no unintended residual atrial shunting, with shunts detected only in 2 patients who underwent intentional baffle fenestration.

Structured PICO

Is transseptal puncture through an intra-atrial patch safe and effective for left heart access in pediatric patients with repaired congenital heart disease?

Population

39 pediatric and young adult patients (age 1-31 years, median 7 years) with an intra-atrial patch (IAP) who underwent transseptal puncture at a single center between November 1979 and February 1998. Cardiac diagnoses included D-transposition of the great arteries after Mustard or Senning procedure, single ventricle variant post-Fontan operation, total anomalous venous return repair, atrioventricular canal repair, and atrial septal defect with patch repair.

Intervention

Transseptal puncture (TSP) through intra-atrial patches (baffles, conduits, pericardial patches, and other prosthetic materials)

Outcome

Efficacy (successful traversal of the intra-atrial patch) and safety (complications and residual atrial shunts on follow-up echocardiogram)safety

Transseptal puncture through an intra-atrial patch is a safe and effective technique for left heart catheterization in patients with repaired congenital heart disease, without causing unintended residual shunting.

Discussion

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Implication

Supports feasibility of transseptal puncture through intra-atrial patches in congenital repairs; leaves open need for prospective validation before wider adoption.

Cite This Study

El-Said et al. (2000) studied this question.

synapsesocial.com/papers/6a71dd06a528af2d65c43ad2 https://doi.org/10.1002/1522-726x(200008)50:4<434::aid-ccd14>3.0.co;2-e

Topics

Congenital heart disease adults Echocardiography

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Implication

Supports feasibility of transseptal puncture through intra-atrial patches in congenital repairs; leaves open need for prospective validation before wider adoption.

18-year experience with transseptal procedures through baffles, conduits, and other intra-atrial patches

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

18-year experience with transseptal procedures through baffles, conduits, and other intra-atrial patches

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider