Can computer tomography help predict feasibility of transseptal puncture after percutaneous closure of an interatrial septal communication?
Background Transseptal puncture (TSP) is the first step in pulmonary vein isolation and catheter ablation, as well as in left atrial appendage closure in atrial fibrillation. Although TSP has been reported to be successful in patients with device closure of interatrial septal communications, questio...
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| Veröffentlicht in: | Journal of interventional cardiac electrophysiology 2012-08, Vol.34 (2), p.167-172 |
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| creator | Wagdi, Philipp Alkadhi, Hatem |
| description | Background
Transseptal puncture (TSP) is the first step in pulmonary vein isolation and catheter ablation, as well as in left atrial appendage closure in atrial fibrillation. Although TSP has been reported to be successful in patients with device closure of interatrial septal communications, questions pertinent to its feasibility in patients with large devices still remain. We sought to determine whether a “safe zone” for TSP could be visualised by computer tomography (CT), especially if larger device sizes for interatrial septal communication closure (IASC-C) had been used.
Methods
Retrospective observational study of 20 patients who underwent CT for
de novo
chest pain occurring after IASC-C or as a diagnostic test for suspected or proven coronary artery disease (CAD). Clinical follow-up was for 20.5 ± 17.6 (6–84) months. CT was done18 ± 10 (2–28) weeks after IASC-C. Device size and dimensions of both atria in the long and short axes were measured, as was the minimal distance of the device edge to the inferior and inferoposterior atrial floor.
Results
The calculated minimal distance from the device edge to the inferior aspect (at 6 o’clock) of the (right or left) atrial floor was 7.2 ± 6.5 (0–27) mm while that to the inferoposterior aspect (at 07:30 o’clock) was 5.3 ± 4.2 (0–15) mm. In both locations, a distance of >6 mm was documented in ten patients (50%) while in nine patients (45%) a space of |
| doi_str_mv | 10.1007/s10840-011-9625-6 |
| format | Article |
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Transseptal puncture (TSP) is the first step in pulmonary vein isolation and catheter ablation, as well as in left atrial appendage closure in atrial fibrillation. Although TSP has been reported to be successful in patients with device closure of interatrial septal communications, questions pertinent to its feasibility in patients with large devices still remain. We sought to determine whether a “safe zone” for TSP could be visualised by computer tomography (CT), especially if larger device sizes for interatrial septal communication closure (IASC-C) had been used.
Methods
Retrospective observational study of 20 patients who underwent CT for
de novo
chest pain occurring after IASC-C or as a diagnostic test for suspected or proven coronary artery disease (CAD). Clinical follow-up was for 20.5 ± 17.6 (6–84) months. CT was done18 ± 10 (2–28) weeks after IASC-C. Device size and dimensions of both atria in the long and short axes were measured, as was the minimal distance of the device edge to the inferior and inferoposterior atrial floor.
Results
The calculated minimal distance from the device edge to the inferior aspect (at 6 o’clock) of the (right or left) atrial floor was 7.2 ± 6.5 (0–27) mm while that to the inferoposterior aspect (at 07:30 o’clock) was 5.3 ± 4.2 (0–15) mm. In both locations, a distance of >6 mm was documented in ten patients (50%) while in nine patients (45%) a space of <6 mm was shown in both locations. There was no correlation between atrial dimensions or device size and minimal device distance to either wall.
Conclusion
With the exception of cases with the smallest devices (18 and 20 mm), neither device size nor atrial dimensions allow us to predict the feasibility of TSP in patients with a clamshell-type interatrial septal device in place, so that CT may be of help in determining whether a safe puncture space does exist in these patients.</description><identifier>ISSN: 1383-875X</identifier><identifier>EISSN: 1572-8595</identifier><identifier>DOI: 10.1007/s10840-011-9625-6</identifier><identifier>PMID: 22314668</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adult ; Aged ; Cardiology ; Feasibility Studies ; Female ; Heart Septal Defects, Atrial - surgery ; Heart Septum - diagnostic imaging ; Heart Septum - surgery ; Humans ; Medicine ; Medicine & Public Health ; Middle Aged ; Percutaneous Coronary Intervention ; Prognosis ; Punctures - methods ; Radiography, Interventional - methods ; Retrospective Studies ; Tomography, X-Ray Computed - methods ; Treatment Outcome</subject><ispartof>Journal of interventional cardiac electrophysiology, 2012-08, Vol.34 (2), p.167-172</ispartof><rights>Springer Science+Business Media, LLC 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-ed1bea4c2fa81e790746dde41bef81d289daac5f6b36d05a3e79ae9b1e7ab9753</citedby><cites>FETCH-LOGICAL-c372t-ed1bea4c2fa81e790746dde41bef81d289daac5f6b36d05a3e79ae9b1e7ab9753</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10840-011-9625-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10840-011-9625-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22314668$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wagdi, Philipp</creatorcontrib><creatorcontrib>Alkadhi, Hatem</creatorcontrib><title>Can computer tomography help predict feasibility of transseptal puncture after percutaneous closure of an interatrial septal communication?</title><title>Journal of interventional cardiac electrophysiology</title><addtitle>J Interv Card Electrophysiol</addtitle><addtitle>J Interv Card Electrophysiol</addtitle><description>Background
Transseptal puncture (TSP) is the first step in pulmonary vein isolation and catheter ablation, as well as in left atrial appendage closure in atrial fibrillation. Although TSP has been reported to be successful in patients with device closure of interatrial septal communications, questions pertinent to its feasibility in patients with large devices still remain. We sought to determine whether a “safe zone” for TSP could be visualised by computer tomography (CT), especially if larger device sizes for interatrial septal communication closure (IASC-C) had been used.
Methods
Retrospective observational study of 20 patients who underwent CT for
de novo
chest pain occurring after IASC-C or as a diagnostic test for suspected or proven coronary artery disease (CAD). Clinical follow-up was for 20.5 ± 17.6 (6–84) months. CT was done18 ± 10 (2–28) weeks after IASC-C. Device size and dimensions of both atria in the long and short axes were measured, as was the minimal distance of the device edge to the inferior and inferoposterior atrial floor.
Results
The calculated minimal distance from the device edge to the inferior aspect (at 6 o’clock) of the (right or left) atrial floor was 7.2 ± 6.5 (0–27) mm while that to the inferoposterior aspect (at 07:30 o’clock) was 5.3 ± 4.2 (0–15) mm. In both locations, a distance of >6 mm was documented in ten patients (50%) while in nine patients (45%) a space of <6 mm was shown in both locations. There was no correlation between atrial dimensions or device size and minimal device distance to either wall.
Conclusion
With the exception of cases with the smallest devices (18 and 20 mm), neither device size nor atrial dimensions allow us to predict the feasibility of TSP in patients with a clamshell-type interatrial septal device in place, so that CT may be of help in determining whether a safe puncture space does exist in these patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Cardiology</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Heart Septal Defects, Atrial - surgery</subject><subject>Heart Septum - diagnostic imaging</subject><subject>Heart Septum - surgery</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Percutaneous Coronary Intervention</subject><subject>Prognosis</subject><subject>Punctures - methods</subject><subject>Radiography, Interventional - methods</subject><subject>Retrospective Studies</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Treatment Outcome</subject><issn>1383-875X</issn><issn>1572-8595</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU2L1jAUhYMozof-ADcScDObOknTpMlK5MVxhIHZKLgraXo7k6FNYj4W72_wT5vSVxHBVS65zznnwkHoDSXvKSH9daJEdqQhlDZKtLwRz9A55X3bSK748zozyRrZ8-9n6CKlJ0KIIq14ic7altFOCHmOfh60w8avoWSIOPvVP0QdHo_4EZaAQ4TJmoxn0MmOdrH5iP2Mc9QuJQhZLzgUZ3KJgPW8OQSIpmTtwJeEzeLTtqqSmmJdBXSOtqpO4hq8FmeNzta7D6_Qi1kvCV6f3kv07ebT18Ntc3f_-cvh411jWN_mBiY6gu5MO2tJoVek78Q0QVd_Z0mnVqpJa8NnMTIxEa5ZZTSosbJ6VD1nl-hq9w3R_yiQ8rDaZGBZ9rMHSpiSknFOKvruH_TJl-jqdRslZa8o2QzpTpnoU4owDyHaVcdjhYatqWFvaqhNDVtTg6iatyfnMq4w_VH8rqYC7Q6kunIPEP-O_p_rL5qTovc</recordid><startdate>20120801</startdate><enddate>20120801</enddate><creator>Wagdi, Philipp</creator><creator>Alkadhi, Hatem</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20120801</creationdate><title>Can computer tomography help predict feasibility of transseptal puncture after percutaneous closure of an interatrial septal communication?</title><author>Wagdi, Philipp ; Alkadhi, Hatem</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-ed1bea4c2fa81e790746dde41bef81d289daac5f6b36d05a3e79ae9b1e7ab9753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Cardiology</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Heart Septal Defects, Atrial - surgery</topic><topic>Heart Septum - diagnostic imaging</topic><topic>Heart Septum - surgery</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Percutaneous Coronary Intervention</topic><topic>Prognosis</topic><topic>Punctures - methods</topic><topic>Radiography, Interventional - methods</topic><topic>Retrospective Studies</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wagdi, Philipp</creatorcontrib><creatorcontrib>Alkadhi, Hatem</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of interventional cardiac electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wagdi, Philipp</au><au>Alkadhi, Hatem</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Can computer tomography help predict feasibility of transseptal puncture after percutaneous closure of an interatrial septal communication?</atitle><jtitle>Journal of interventional cardiac electrophysiology</jtitle><stitle>J Interv Card Electrophysiol</stitle><addtitle>J Interv Card Electrophysiol</addtitle><date>2012-08-01</date><risdate>2012</risdate><volume>34</volume><issue>2</issue><spage>167</spage><epage>172</epage><pages>167-172</pages><issn>1383-875X</issn><eissn>1572-8595</eissn><abstract>Background
Transseptal puncture (TSP) is the first step in pulmonary vein isolation and catheter ablation, as well as in left atrial appendage closure in atrial fibrillation. Although TSP has been reported to be successful in patients with device closure of interatrial septal communications, questions pertinent to its feasibility in patients with large devices still remain. We sought to determine whether a “safe zone” for TSP could be visualised by computer tomography (CT), especially if larger device sizes for interatrial septal communication closure (IASC-C) had been used.
Methods
Retrospective observational study of 20 patients who underwent CT for
de novo
chest pain occurring after IASC-C or as a diagnostic test for suspected or proven coronary artery disease (CAD). Clinical follow-up was for 20.5 ± 17.6 (6–84) months. CT was done18 ± 10 (2–28) weeks after IASC-C. Device size and dimensions of both atria in the long and short axes were measured, as was the minimal distance of the device edge to the inferior and inferoposterior atrial floor.
Results
The calculated minimal distance from the device edge to the inferior aspect (at 6 o’clock) of the (right or left) atrial floor was 7.2 ± 6.5 (0–27) mm while that to the inferoposterior aspect (at 07:30 o’clock) was 5.3 ± 4.2 (0–15) mm. In both locations, a distance of >6 mm was documented in ten patients (50%) while in nine patients (45%) a space of <6 mm was shown in both locations. There was no correlation between atrial dimensions or device size and minimal device distance to either wall.
Conclusion
With the exception of cases with the smallest devices (18 and 20 mm), neither device size nor atrial dimensions allow us to predict the feasibility of TSP in patients with a clamshell-type interatrial septal device in place, so that CT may be of help in determining whether a safe puncture space does exist in these patients.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>22314668</pmid><doi>10.1007/s10840-011-9625-6</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1383-875X |
| ispartof | Journal of interventional cardiac electrophysiology, 2012-08, Vol.34 (2), p.167-172 |
| issn | 1383-875X 1572-8595 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Cardiology Feasibility Studies Female Heart Septal Defects, Atrial - surgery Heart Septum - diagnostic imaging Heart Septum - surgery Humans Medicine Medicine & Public Health Middle Aged Percutaneous Coronary Intervention Prognosis Punctures - methods Radiography, Interventional - methods Retrospective Studies Tomography, X-Ray Computed - methods Treatment Outcome |
| title | Can computer tomography help predict feasibility of transseptal puncture after percutaneous closure of an interatrial septal communication? |
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