Full-color direct visualization of the atrial septum to guide transseptal puncture

Aravinda Thiagalingam, Andre D'Avila, Lori Foley, Melodie Fox, Chris Rothe, David Miller, Zach Malchano, Jeremy N. Ruskin, Vivek Y. Reddy

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Transseptal Puncture Using Direct Visualization. Introduction: Transseptal puncture is required for many interventional procedures but has a serious complication rate of ∼1% - primarily related to misidentification of the fossa ovalis resulting in inadvertent puncture of other cardiac structures. We investigated the utility of a full color visualization catheter to correctly position and guide transseptal puncture of the fossa ovalis. Methods and Results: Transseptal puncture and left atrial cannulation were performed after visualization of the atrial septum and fossa ovalis with the visualization catheter (IRIS, Voyage Medical Inc.) on six swine. For each animal, the transseptal puncture was performed twice and the catheter was examined for clot after each puncture. The 12 transseptal punctures required 6.8 ± 3.6 minutes procedural time and 300 ± 94 mL of fluid administered per procedure (i.e., two punctures). IRIS visualization of the atrial septum correlated well with postmortem examination of the atrial septum. In the three animals in which a patent foramen ovale was present (as confirmed by pathological examination), it was also correctly identified by in vivo visualization using the IRIS catheter. Conclusion: The IRIS catheter allows direct in vivo visualization of the interatrial septum to guide transseptal puncture of previous punctures.

Original languageEnglish
Pages (from-to)1310-1315
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume19
Issue number12
DOIs
StatePublished - Dec 2008
Externally publishedYes

Keywords

  • Atrial fibrillation
  • Atrium
  • Catheter ablation
  • Electrophysiology
  • Valvuloplasty

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