Key result
Left ventricular ablation via a transseptal approach crossing a mechanical mitral valve was successfully performed without complications in a patient with an LVAD and refractory ventricular tachycardia.
Case Report (n=1)
Demonstrates the feasibility and safety of performing LV mapping and ablation via a transseptal approach crossing a mechanical mitral valve in a patient with an LVAD.
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Transseptal LV ablation across mechanical mitral valve appears feasible in LVAD patients; leaves open generalizability and safety beyond this single case.
This report describes the clinical course of a patient with left ventricular assist device (LVAD) and refractory ventricular tachycardia (VT) who underwent successful left ventricular (LV) mapping and ablation complicated by the presence of a bioprosthetic aortic and a mechanical mitral valve. LV catheterization was achieved by crossing the mechanical valve. The patient remained hemodynamically stable during the procedure most likely as a result of LVAD support. There were no complications. A recurrence of monomorphic VT 2 months later required a second VT ablation procedure using the same transseptal-transmitral approach. The patient has since been free of implantable cardioverter defibrillator shocks for 2 months since the second procedure.
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Herweg et al. (2010) conducted a case report in Refractory ventricular tachycardia in a patient with LVAD, bioprosthetic aortic valve, and mechanical mitral valve (n=1). Left ventricular mapping and ablation via transseptal approach crossing a mechanical mitral valve was evaluated on Procedural success and freedom from ICD shocks. Left ventricular ablation via a transseptal approach crossing a mechanical mitral valve was successfully performed without complications in a patient with an LVAD and refractory ventricular tachycardia.
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