Right Internal Jugular Transseptal Puncture for Wolff–Parkinson–White Ablation in a Patient with Interrupted Inferior Vena Cava and Azygos Continuation-Uncorrected Proof
Year: 2026
Type: article
Study design: Case Report
Abstract: Catheter ablation of left-sided accessory pathways typically requires femoral venous access with transseptal puncture; however, congenital interruption of the inferior vena cava (IVC) with azygos continuation makes this approach impractical.We report a 20-year-old man with Wolff-Parkinson-White syndrome in whom an interrupted IVC with azygos continuation was discovered during the procedure.After failed attempts using a retrograde aortic approach due to poor catheter stability, left atrial access was successfully achieved via a right internal jugular vein transseptal puncture guided by biplane fluoroscopy alone.A deflectable sheath provided stable mapping and enabled successful ablation of a left free-wall accessory pathway without complications.Postprocedural computed tomography confirmed the venous anomaly.This case highlights the right internal jugular vein transseptal approach as a feasible and effective alternative for left atrial access in patients with interrupted IVC when femoral access is not possible, provided the procedure is performed in experienced centers.
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7224259991