Work

Taking a Detour: Step‐by‐Step Alternative Approaches to Transseptal Access

Year: 2025

Type: article

Abstract: Transseptal puncture via a femoral vein and inferior vena cava (IVC) is a commonly performed procedure in multiple electrophysiology studies that require access to the left atrium or left ventricle. However, the standard approach is impossible in certain anatomies with IVC obstruction, such as congenital IVC interruption with azygos continuation and acquired obstruction. Here, we describe a step-by-step approach to alternative methods for transseptal access, including the transhepatic approach and superior approach from either the internal jugular vein or axillary vein. With careful review of multi-modal imaging and multidisciplinary preprocedural planning, these methods are feasible and safe alternatives to transseptal access.

Source: Journal of Cardiovascular Electrophysiology

DOI: 10.1111/jce.16711

Authors: Worawan B. Limpitikul, Vincent Wu, Kei Yamada, Gregory F. Michaud, William J. Hucker, Moussa Mansour, E. Kevin Heist, Alan Hanley

Institutions: Harvard University, Massachusetts General Hospital, Tufts Medical Center, Beth Israel Deaconess Medical Center

Language: English

Topic: Cardiac Arrhythmias and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

OpenAlex ID: W4410695524

FWCI: 0.649

Cites: 23

Cited by: 1

Related to: 10