Feasibility of Transseptal Access in XXXX with Previously Scarred or Repaired Inter-atrial Septum.

@entity1 @entity955 @entity70684
BACKGROUND: Many @entity1 (pts) with interatrial septal repair (ASR) and /or multiple prior transseptal puncture (MTSP) are being referred for @entity955 ( @entity955 ) ablation. We examine the feasibility of repeat TSP in these settings. METHODS: Records were reviewed from a single center from 2001 to 2012. Criteria for MTSP was >2 priorAF ablation procedures and criteria for ASR was prior surgical or percutaneous interatrial septal repair. Intracardiac echocardiography (ICE) was used for all procedures. Repeat transseptal puncture (TSP) outcomes were classified as 1) routine, 2) challenging (additional tools, sheaths, multiple attempts) 3) failed, or 4) complicated (adverse event possibly related to TSP). Five hundred pts selected at random over the same time period undergoing 1(st) @entity955 without history of prior cardiac surgery were used as control. RESULTS: Two hundred and fifty-one pts met criteria (MTSP = 224; ASR = 27). TSP was routinely accomplished in majority [212 pts (95%) in MTSP; 20 pts (74%) in ASR]. In the MTSP group, the number of challenging/failed cases increased proportionately with number of prior @entity955 procedures. There were no complications in the @entity70684 (1%) in MTSP. This was not different from that in the control arm [n = 6 (1%); p = ns). Pericardial effusion was the only complication seen in all groups. CONCLUSIONS: In the majority of pts with scarred and/or repaired IAS, repeat TSP can be routinely accomplished using ICE guidance without any other special tools. Although repeat TSP can be occasionally difficult in pts with MTSP and ASR, it can be accomplished in the majority without serious complications. This article is protected by copyright. All rights reserved.
