Case Report: A novel method of needle-free transseptal puncture

Chia-Chen Lee; Chen-An Chao; Su-Huan Chang; Chun-Kai Chen; Yen-Siou Chen; Chang-En Lin; Tsung-Ping Jeng; Chih-Chieh Yu

doi:10.3389/fcvm.2024.1493240

Case Report: A novel method of needle-free transseptal puncture

Front Cardiovasc Med. 2024 Dec 3:11:1493240. doi: 10.3389/fcvm.2024.1493240. eCollection 2024.

Authors

Chia-Chen Lee^{1

2}, Chen-An Chao^{1

2}, Su-Huan Chang^{1

2}, Chun-Kai Chen^{1

2}, Yen-Siou Chen^{2

3}, Chang-En Lin^{1

2}, Tsung-Ping Jeng^{1

2}, Chih-Chieh Yu^{1

2}

Affiliations

¹ Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
² Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.
³ Department of Cardiology, Fu Jen Catholic University Hospital, Taipei, Taiwan.

Abstract

Background: In the era of fluoroless catheter ablation (CA), achieving a successful transseptal puncture (TSP) presents a significant challenge. We introduce a novel technique for zero-fluoroscopy and cost-effective needle-free TSP.

Case summary: We describe two cases where a GMS-1 guidewire (0.025 inch, pigtail configuration; Toray Medical Co., Ltd., Japan) was utilized for TSP. This technique was performed using either fluoroscopy or intracardiac echocardiography (ICE). The procedure was completed successfully in both cases, with no complications reported.

Conclusion: The use of a 0.025 inch GMS-1 guidewire with an electrocautery technique enables effective transseptal puncture without the need for a needle or fluoroscopy. This novel approach offers a safe, efficient, and zero-fluoroscopic alternative for TSP.

Keywords: atrial fibrillation; electrocautery; electrophysiology; intracardiac echocardiography; transseptal puncture.

Publication types

Case Reports