Simplified Method for Insertion of Steerable Guide into the Left Atrium Using a Pigtail Guide Wire During the MitraClip((R)) Procedure: A Technical Tip

Buchner, Stefan and Dreher, Ansgar and Resch, Markus and Schach, Christian and Birner, Christoph and Luchner, Andreas (2015) Simplified Method for Insertion of Steerable Guide into the Left Atrium Using a Pigtail Guide Wire During the MitraClip((R)) Procedure: A Technical Tip. JOURNAL OF INTERVENTIONAL CARDIOLOGY, 28 (5). pp. 472-478. ISSN 0896-4327, 1540-8183

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Abstract

BackgroundTo assess whether a new floppy pigtail guidewire provides sufficient support for introduction of the 22F-steerable guide catheter (SG) into the left atrium and is less time-consuming during the MitraClip((R))-procedure without necessity of probing and inserting a stiff wire into the pulmonary vein. MethodsIn group 1, traditional probing of the left upper pulmonary vein and insertion of a standard stiff wire was used. In group 2, direct insertion of the floppy pigtail guidewire directly after transseptal puncture was used. ResultsPatients in group 1 (n=18) and group 2 (n=21) did not differ significantly with respect to mitral regurgitation severity (3.20.4 vs 3.2 +/- 0.4; P=0.814) and etiology (functional 78% vs 71%, P=0.651). Comparing both methods, a significant reduction in time-to-SG was observed in group 2 versus group 1 (17 +/- 7 minutes vs 30 +/- 11 minutes; P=0.001). The rate of crossing failures was 0% with use of the floppy pigtail guidewire as well as with the traditional technique. No complications were observed with use of the floppy pigtail guidewire. ConclusionsUtilization of a thin, floppy pigtail guidewire for left atrium access is safe and markedly accelerates insertion of the SG for the MitraClip((R))-procedure without crossing failures of the atrial septum. (J Interven Cardiol 2015;28:472-478)

Item Type: Article
Uncontrolled Keywords: MITRAL REGURGITATION; CLINICAL-OUTCOMES; VALVE REPAIR; THERAPY;
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Innere Medizin II
Depositing User: Dr. Gernot Deinzer
Date Deposited: 06 Jun 2019 10:23
Last Modified: 06 Jun 2019 10:23
URI: https://pred.uni-regensburg.de/id/eprint/4717

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