A Novel Deep Inspiration Maneuver for Difficult Transseptal Puncture

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dc.authorid0000-0001-8061-9660
dc.authorscopusid23666427000
dc.authorscopusid12760152200
dc.authorscopusid35747185700
dc.authorscopusid17134926000
dc.authorscopusid55153235900
dc.authorscopusid7005837198
dc.authorwosidYalin, Kivanc/M-7118-2013
dc.contributor.authorAksu, Tolga
dc.contributor.authorGüler, Tümer Erdem
dc.contributor.authorYalın, Kıvanç
dc.contributor.authorGölcük, Şükriye Ebru
dc.contributor.authorÖzcan, Kazım Serhan
dc.contributor.authorGüler, Niyazi
dc.date.accessioned2022-05-11T14:40:09Z
dc.date.available2022-05-11T14:40:09Z
dc.date.issued2017
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kardiyoloji Ana Bilim Dalı
dc.description.abstractTransseptal puncture (TSP) may not be possible in cases of an elastic, aneurysmal, or thickened interatrial septum (IAS). During deep inspiration (DI), the chest wall expands and the diaphragm descends. This makes intrapleural pressure to become more negative, which leads to movement of the IAS to the right side. The aim of this study was to verify prospectively the feasibility, safety, and outcome of DI associated with conventional TSP technique in patients with challenging IAS anatomy. From September 2012 to May 2016, 224 patients underwent TSP due to different indications. Patients were divided into 2 groups: 213 patients in whom the left atrium was successfully accessed in 3 attempts were grouped as conventional TSP group and 11 patients in whom left atrium access was failed after 3 conventional attempts were grouped as DI-TSP group. Conventional TSP was successful in 89.6% of patients with the first attempt. Second and third attempts were required in 4.1% and 1.4%, respectively. Septal puncture was achieved at the first attempt in 10 patients within a median of 1 second of DI maneuver (interquartile range, 1 to 3) and without any complications. Challenging IAS anatomy consisting of IAS aneurysm, a thick IAS, and an excessively mobile IAS were more frequent in the DI-TSP group (45% to 8%, 27% to 3%, and 21% to 5%, respectively, p <0.001). In conclusion, TSP by using the DI maneuver may be a reliable and safe method after failed conventional attempts. If there is any doubt about the correct location of the needle, additional imaging modalities have to be used. (C) 2016 Elsevier Inc. All rights reserved.
dc.identifier.doi10.1016/j.amjcard.2016.10.023
dc.identifier.endpage433
dc.identifier.issn0002-9149
dc.identifier.issn1879-1913
dc.identifier.issue3en_US
dc.identifier.pmid27884419
dc.identifier.scopus2-s2.0-85006971375
dc.identifier.scopusqualityQ1
dc.identifier.startpage428
dc.identifier.urihttps://doi.org/10.1016/j.amjcard.2016.10.023
dc.identifier.urihttps://hdl.handle.net/20.500.11776/8882
dc.identifier.volume119
dc.identifier.wosWOS:000393533200013
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorGüler, Niyazi
dc.language.isoen
dc.publisherExcerpta Medica Inc-Elsevier Science Inc
dc.relation.ispartofAmerican Journal of Cardiology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectAtrial-Fibrillation Ablation
dc.subjectMitral-Valve Repair
dc.subjectSeptal Catheterization
dc.subjectSystem
dc.subjectComplications
dc.subjectGuidewire
dc.subjectDelivery
dc.subjectNeedle
dc.subjectAccess
dc.titleA Novel Deep Inspiration Maneuver for Difficult Transseptal Puncture
dc.typeArticle

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