Latest Advances in Transseptal Structural Heart Interventions

Matsumoto, Takashi; Kar, Saibal

doi:10.1253/circj.cj-14-0681

Cited by 14 publications

(3 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…LAA-Occluder dislocation occurred in the +EchoNav group and an intermittent third-degree AV-block occurred periprocedurally during LAA closure in the −EchoNav group. Concerning occurrence and characteristics of adverse events they are consistent with results from earlier studies [13, 14]. Time to TSP of around 20 min seems to be quite long at first sight, but as is stated in the Methods section, we started to count from the exact beginning of the procedure with local anaesthesia.…”

Section: Discussionsupporting

confidence: 82%

Safety and efficacy of transseptal puncture guided by real-time fusion of echocardiography and fluoroscopy

et al. 2016

View full text Add to dashboard Cite

AimsVisual guidance through echocardiography and fluoroscopy is crucial for a successful transseptal puncture (TSP) in a prespecified region of the fossa ovalis. The novel EchoNavigator system Release II (EchoNav II, Philips Healthcare, Andover, Massachusetts, USA) enables the real-time fusion of fluoroscopic and echocardiographic images. We evaluated this new imaging method in respect to safety and efficacy of TSP during MitraClip implantation and left atrial appendage closure.MethodsForty-four patients before (−EchoNav) and 44 patients after (+EchoNav) the introduction of real-time fusion were included in our retrospective, single-centre study. The primary endpoint was the occurrence of adverse events due to TSP. Secondary endpoints were successful puncture at the prespecified region and time until TSP (min).ResultsIn both groups TSP was performed successfully in the prespecified region and no adverse events occurred during or due to the accomplishment of TSP. Time until TSP was significantly reduced in the +EchoNav group in comparison with the EchoNav group (18.48 ± 5.62 min vs. 23.20 ± 9.61 min, p = 0.006).ConclusionsReal-time fusion of echocardiography and fluoroscopy proved to be as safe and successful as standard best practice for TSP. Moreover, efficacy was improved through significant reduction of time until TSP.

show abstract

Section: Discussionsupporting

confidence: 82%

Safety and efficacy of transseptal puncture guided by real-time fusion of echocardiography and fluoroscopy

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The identification of the relevant works was performed using Prisma Statement [13]. [2] Recent advances in transseptal left heart interventions. 2012 Kautzner et al [81] Review of imaging techniques used in LA procedures.…”

Section: Abnormal Position Of the Fomentioning

confidence: 99%

“…Percutaneous access of the left atrium (LA) is required in a large number of minimally invasive procedures, such as catheter ablation for atrial fibrillation, paravalvular leakage repair, percutaneous mitral valve replacement and left atrial appendage closure [1,2]. These procedures are frequently performed (Table 1) being a preferred practice to the traditional open-chest surgery, due to the lower costs and lower complication rate.…”

Section: Introductionmentioning

confidence: 99%

Novel Solutions Applied in Transseptal Puncture: A Systematic Review

Morais

Vilaça²,

Ector

et al. 2017

Journal of Medical Devices

View full text Add to dashboard Cite

Access to the left atrium is required for several minimally invasive cardiac interventions in the left heart. For this purpose, transseptal puncture (TSP) technique is often performed, perforating the atrial septum under fluoroscopic or/and ultrasound imaging guidance. Although this approach has been used for many years, complications/failures are not uncommon mainly in patients with abnormal atrial anatomy and repeated TSP. Thus, this study presents an overview of methods and techniques that have been proposed to increase the safety and feasibility of the TSP. A systematic review of literature was conducted through the analysis of the articles published between 2008 and 2015. The search was performed in PubMed, Scopus, and ISI Web of Knowledge using the expression “transseptal puncture.” A total of 354 articles were retrieved from the databases, and 64 articles were selected for this review. Moreover, these 64 articles were divided into four categories, namely: (1) incidence studies, (2) intraprocedural guidance techniques, (3) preprocedural planning methods, and (4) surgical instruments. A total of 36 articles focused on incidence studies, 24 articles suggested novel intraprocedural guidance techniques, 5 works focused on preprocedural planning strategies, and 21 works proposed surgical instruments. The novel 3D guidance techniques, radio-frequency surgical instruments, and pre-interventional planning approaches showed potential to overcome the main procedural limitations/complications, through the reduction of the intervention time, radiation, number of failures, and complications.

show abstract