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Antegrade selective coronary angiography via the transseptal approach in a patient with severe vascular disease
A C Pearce1, R H Schwengel, L M Simione
1University of Maryland Division of Cardiology, Baltimore 21201.
Insights
Transseptal catheterization enabled selective antegrade angiography in a patient with severe vascular disease limiting retrograde aortic root access. This approach facilitated aortic valve intervention planning.
Area of Science:
- Cardiovascular medicine
- Interventional cardiology
- Vascular surgery
Background:
- Severe vascular disease poses challenges for accessing the aortic root.
- Retrograde access is often preferred for aortic interventions but can be limited by aortoiliac and axillary occlusive disease.
Observation:
- A patient presented with severe aortoiliac and axillary vascular disease, precluding standard retrograde access to the aortic root.
- Transseptal catheterization was considered as an alternative access strategy.
Findings:
- Transseptal catheterization was successfully performed, establishing an antegrade access route.
- Selective antegrade angiography of the aortic root was achieved using catheters introduced through the transseptal sheath.
Implications:
- Transseptal catheterization offers a viable alternative for aortic root access in complex vascular disease.
- This technique may expand treatment options for patients requiring aortic interventions, such as percutaneous aortic valvuloplasty.
Abstract:
We describe a case of a woman with severe vascular disease in whom retrograde access to the aortic root was limited by both aortoiliac and axillary disease. Transseptal catheterization was performed in anticipation of percutaneous aortic valvuloplasty. Selective antegrade angiography was successfully performed using catheters introduced through the transseptal sheath.