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

Simplified Method for Insertion of Steerable Guide into the Left Atrium Using a Pigtail Guide... Background To 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®‐procedure without necessity of probing and inserting a stiff wire into the pulmonary vein. Methods In 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. Results Patients in group 1 (n = 18) and group 2 (n = 21) did not differ significantly with respect to mitral regurgitation severity (3.2 ± 0.4 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. Conclusions Utilization of a thin, floppy pigtail guidewire for left atrium access is safe and markedly accelerates insertion of the SG for the MitraClip®‐procedure without crossing failures of the atrial septum. (J Interven Cardiol 2015;28:472–478) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Interventional Cardiology Wiley

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

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References (8)

Publisher
Wiley
Copyright
© 2015 Wiley Periodicals, Inc.
ISSN
0896-4327
eISSN
1540-8183
DOI
10.1111/joic.12224
pmid
26346179
Publisher site
See Article on Publisher Site

Abstract

Background To 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®‐procedure without necessity of probing and inserting a stiff wire into the pulmonary vein. Methods In 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. Results Patients in group 1 (n = 18) and group 2 (n = 21) did not differ significantly with respect to mitral regurgitation severity (3.2 ± 0.4 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. Conclusions Utilization of a thin, floppy pigtail guidewire for left atrium access is safe and markedly accelerates insertion of the SG for the MitraClip®‐procedure without crossing failures of the atrial septum. (J Interven Cardiol 2015;28:472–478)

Journal

Journal of Interventional Cardiology – Wiley

Published: Oct 1, 2015

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