Transseptal access for left heart structural interventions in the setting of prior atrial septal defect closure

Research output: Contribution to journalReview article

Abstract

A transseptal puncture is critical for “left-sided” structural heart interventions. Procedures such as transcatheter edge-to-edge repair (MitraClip) and left atrial appendage (LAA) closure (Watchman) require precise puncture of the interatrial septum (IAS), and the presence of a prior atrial septal defect (ASD) closure device poses a challenge. We aim to present a successfully completed case of MitraClip and Watchman in the presence of ASD closure device in two different patients. A review of the literature will be reported, and pertinent clinical and technical considerations will be discussed in depth to achieve procedural success. In summary, transseptal puncture for left heart structural interventions is feasible in the presence of a prior ASD/patent foramen ovale closure device. A detailed understanding of the anatomical considerations as well as the use of multimodality imaging to evaluate the IAS will aid in improving procedural success rates.

Original languageEnglish (US)
JournalCatheterization and Cardiovascular Interventions
DOIs
StateAccepted/In press - Jan 1 2019

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Atrial Heart Septal Defects
Punctures
Equipment and Supplies
Patent Foramen Ovale
Atrial Appendage

Keywords

  • ASD/PDA/PFO
  • catheterization
  • closure
  • structural heart disease intervention
  • transseptal

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{3c043304b1de44db932702d2e5dd378e,
title = "Transseptal access for left heart structural interventions in the setting of prior atrial septal defect closure",
abstract = "A transseptal puncture is critical for “left-sided” structural heart interventions. Procedures such as transcatheter edge-to-edge repair (MitraClip) and left atrial appendage (LAA) closure (Watchman) require precise puncture of the interatrial septum (IAS), and the presence of a prior atrial septal defect (ASD) closure device poses a challenge. We aim to present a successfully completed case of MitraClip and Watchman in the presence of ASD closure device in two different patients. A review of the literature will be reported, and pertinent clinical and technical considerations will be discussed in depth to achieve procedural success. In summary, transseptal puncture for left heart structural interventions is feasible in the presence of a prior ASD/patent foramen ovale closure device. A detailed understanding of the anatomical considerations as well as the use of multimodality imaging to evaluate the IAS will aid in improving procedural success rates.",
keywords = "ASD/PDA/PFO, catheterization, closure, structural heart disease intervention, transseptal",
author = "Jonathan Yap and Sarah Chen and Stripe, {Benjamin R.} and Smith, {Thomas W.R.} and Rogers, {Jason H.} and Singh, {Gagan D.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1002/ccd.28548",
language = "English (US)",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
publisher = "Wiley-Liss Inc.",

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TY - JOUR

T1 - Transseptal access for left heart structural interventions in the setting of prior atrial septal defect closure

AU - Yap, Jonathan

AU - Chen, Sarah

AU - Stripe, Benjamin R.

AU - Smith, Thomas W.R.

AU - Rogers, Jason H.

AU - Singh, Gagan D.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - A transseptal puncture is critical for “left-sided” structural heart interventions. Procedures such as transcatheter edge-to-edge repair (MitraClip) and left atrial appendage (LAA) closure (Watchman) require precise puncture of the interatrial septum (IAS), and the presence of a prior atrial septal defect (ASD) closure device poses a challenge. We aim to present a successfully completed case of MitraClip and Watchman in the presence of ASD closure device in two different patients. A review of the literature will be reported, and pertinent clinical and technical considerations will be discussed in depth to achieve procedural success. In summary, transseptal puncture for left heart structural interventions is feasible in the presence of a prior ASD/patent foramen ovale closure device. A detailed understanding of the anatomical considerations as well as the use of multimodality imaging to evaluate the IAS will aid in improving procedural success rates.

AB - A transseptal puncture is critical for “left-sided” structural heart interventions. Procedures such as transcatheter edge-to-edge repair (MitraClip) and left atrial appendage (LAA) closure (Watchman) require precise puncture of the interatrial septum (IAS), and the presence of a prior atrial septal defect (ASD) closure device poses a challenge. We aim to present a successfully completed case of MitraClip and Watchman in the presence of ASD closure device in two different patients. A review of the literature will be reported, and pertinent clinical and technical considerations will be discussed in depth to achieve procedural success. In summary, transseptal puncture for left heart structural interventions is feasible in the presence of a prior ASD/patent foramen ovale closure device. A detailed understanding of the anatomical considerations as well as the use of multimodality imaging to evaluate the IAS will aid in improving procedural success rates.

KW - ASD/PDA/PFO

KW - catheterization

KW - closure

KW - structural heart disease intervention

KW - transseptal

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U2 - 10.1002/ccd.28548

DO - 10.1002/ccd.28548

M3 - Review article

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JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

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