Use of a novel needle wire in patients undergoing transseptal puncture associated with severe septal tenting

Abstract

Additional use of a needle wire to perform transseptal puncture in a subset of patients at higher risk for complications appears safe and effective.

Incidence of Tissue Coring During Transseptal Catheterization When Using Electrocautery and a Standard Transseptal Needle

“…This wire is a small-caliber, sharp-tipped, J-shaped guide wire that can be safely advanced across the interatrial septum into the left atrium through the lumen of a standard transseptal needle. 15 Limitations A limitation of this study was the lack of histological examination of the material that was flushed from the needle after TSP. It is therefore not clear how much of the cores represent cardiac tissue.…”

Novel Solutions Applied in Transseptal Puncture: A Systematic Review

“…Table 4 presents a review of the total number of TSP performed between 2008 and April of 2015. Several studies use heterogeneous populations, which includes: children's [15][16][17], abnormal atria anatomy [10,[18][19][20][21][22][23][24][25][26] and patients with previous TSP [7,8,[27][28][29][30][31][32]. The number of puncture attempts, failures and complications were registered.…”

“…Furthermore, some authors proposed novel solutions for the remaining surgical equipment's, particularly: dilator, guidewire and catheters. Thereby, a new dilator approach [66], a laser catheter and a nitinol guidewire with "J" shape [21,22,67] were suggested to prevent inadvertent puncture and reduce complication rate.…”

“…Although several authors proposed and validated novel needles to safely perform TSP, novel solutions were also presented for the remaining equipment: nitinol guidewires [21,22,67,74] and laser catheters [44]. Nitinol guidewire (SafeSeptTM, Pressure Products Inc., San Pedro, USA) presents a "J" preformed with 0.014″ wire and a sharp-distal tip.…”

“…Furthermore, this novel guidewire has a radiopaque marker at the guidewire tip, facilitating instrument identification in fluoroscopy. This novel solution was compared with the traditional TSP strategies in humans, showing a high success rate even in difficult procedures [21,22,67,74].…”