Needle-free, Novel Fossa Ovalis Puncture with Percutaneous Transluminal Coronary Angioplasty Guidewire and Microcatheter in Pigs and a Human with an Extremely Tortuous Inferior Vena Cava

作者全名：Wang, Guang-Xia; Luo, Hong; Jia, Feng-Peng; Li, Run-Tu; He, Quan; Qin, Chun -Chang

作者地址：[Wang, Guang-Xia; Luo, Hong; Jia, Feng-Peng; Li, Run-Tu; He, Quan; Qin, Chun -Chang] Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiol, Chongqing 400017, Peoples R China

通信作者：He, Q; Qin, CC (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiol, Chongqing 400017, Peoples R China.

来源：REVIEWS IN CARDIOVASCULAR MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001238696500016

JCR分区：Q3

影响因子：1.9

年份：2024

卷号：25

期号：5

开始页：　

结束页：　

文献类型：Article

关键词：fossa ovalis; microcatheter; percutaneous transluminal coronary angioplasty guidewire; needle -free; transseptal puncture

摘要：Background: Transseptal puncture (TSP) performed with the Brockenbrough (BRK) needle is technically demanding and carries potential risks. The back end of the percutaneous transluminal coronary angioplasty (PTCA) guidewire is blunt and flexible, with good support, it can puncture the right ventricle-free wall, which is thicker than the atrial-septum. The guidewire is thin and easy to manipulate. This study evaluated the performance of TSP with a PTCA guidewire and microcatheter without a needle. Methods: The back end of a PTCA guidewire was advanced into the Tiger (TIG) catheter, within the SL1 sheath, to puncture the fossa ovalis (FO) under fluoroscopy. Subsequently, the microcatheter was inserted into the left atrium (LA) above the guidewire, and the front end of the guidewire was exchanged in the LA. After the puncture site was confirmed by contrast, the TIG catheter and a 0.032 inch wire were advanced into the LA. Finally, the sheath, with the dilator, was advanced over the wire into the LA. The safety margin of this method was tested in a pig model. Results: The puncture was successful in all seven pigs tested with a puncture-to-sheath entry time of <20 minutes and no procedure-related complications. The method was successfully used to perform a difficult TSP in a patient with an extremely tortuous inferior vena cava, in whom puncture with a BRK needle had repeatedly failed. Conclusions: Cardiologists may use the PTCA guidewire and microcatheter as an alternative to the needle while performing TSP in special conditions, such as an extremely tortuous inferior vena cava.

基金机构：National Natural Science Foundation of China [82070523]; Chongqing Science and Technology Bureau [cstc2019jscx-msxmX0307]; Chongqing Health Com-mission [2020msxm113]

基金资助正文：This research was funded by the National Natural Science Foundation of China, grant number 82070523; Chongqing Science and Technology Bureau, grant number cstc2019jscx-msxmX0307; and Chongqing Health Com-mission, grant number 2020msxm113.