Premium
Initial clinical experience with the FlexPoint Steerable Transseptal Needle in left‐sided structural heart procedures
Author(s) -
Rogers Jason H.,
Stripe Benjamin R.,
Singh Gagan D.,
Boyd Walter D.,
Fan Dali,
Smith Thomas W.R.
Publication year - 2018
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27685
Subject(s) - medicine , interatrial septum , deflection angle , stylet , mitral valve , surgery , atrial septum , radiology , atrial fibrillation , left atrium , cardiology , physics , optics
Objectives The purpose of this study is to describe the initial clinical experience with a steerable transseptal needle (STSN) for left‐sided structural heart procedures. Background Targeted transseptal (TS) puncture is required for many structural heart procedures, and the use of a steerable needle has not previously been described. Methods Consecutive patients undergoing structural heart interventions with targeted TS puncture under transesophageal echocardiographic (TEE) and fluoroscopic guidance were studied. The STSN was used in all patients with a standard commercial TS sheath. Deflection of the needle was performed “real time” to achieve localization of the TS puncture site. Results Twenty‐seven patients underwent STSN puncture of the interatrial septum. In all cases, the needle could be deflected in vivo to achieve optimal tenting and localization of the puncture site without having to remove or reshape the needle. The needle was deflected to match a wide range of right atrial diameters (width 4.3 ± 0.9 cm and length 6.0 ± 0.9 cm in the 4‐chamber view). In two patients with prior mitral valve surgery and a fibrotic septum, assisted crossing was achieved using the piercing stylet in one patient, and Bovie energy in the other. There were no procedural complications, and all patients had successful completion of the intended structural heart procedure. Conclusions The STSN needle can be used to target the intended puncture location on the interatrial septum with real‐time adjustable deflection without the need to remove and reshape the needle. In all cases crossing was successful and there were no complications.