A Proposed Maneuver to Guide Transseptal Puncture Using Real-Time Three-Dimensional Transesophageal Echocardiography: Pilot Study

Aim of Study. To assess the feasibility of a new proposed maneuver “RATLe-90” using real-time three-dimensional transesophageal echocardiography (RT-3DTEE) for anatomically oriented visualization of the interatrial septum (IAS) in guiding the transseptal puncture TSP. Methods. The study included 20...

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Main Authors: Hani M. Mahmoud, Mohammed A. Al-Ghamdi, Abdullah E. Ghabashi, Ashraf M. Anwar
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2015/174051
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author Hani M. Mahmoud
Mohammed A. Al-Ghamdi
Abdullah E. Ghabashi
Ashraf M. Anwar
author_facet Hani M. Mahmoud
Mohammed A. Al-Ghamdi
Abdullah E. Ghabashi
Ashraf M. Anwar
author_sort Hani M. Mahmoud
collection DOAJ
description Aim of Study. To assess the feasibility of a new proposed maneuver “RATLe-90” using real-time three-dimensional transesophageal echocardiography (RT-3DTEE) for anatomically oriented visualization of the interatrial septum (IAS) in guiding the transseptal puncture TSP. Methods. The study included 20 patients (mean age, 60.2±6.7 years; 60% males) who underwent TSP for different indications. RT-3DTEE was used to guide TSP. The proposed maneuver RATLe-90 (Rotate-Anticlockwise-Tilt-Left-90) was applied in all cases to have the anatomically oriented en face view of the IAS from the right atrial (RA) aspect. Having this anatomically oriented view, we guided the TSP catheter towards the proper puncture site according to the planned procedure. Results. Using the RATLe-90 maneuver, the anatomically oriented en face view of the IAS from the RA was obtained in all patients. We were able to guide the puncture catheter to the proper puncture site on the IAS. The 3D images obtained were clearly understood by both echocardiographers and interventionists. The RATLe-90 maneuver acquisition time was 19.9±1.6 seconds. The time-to-tent was 64.8±16.3 seconds. Less TEE probe manipulations were needed while guiding the TSP. Conclusions. Application of RT3D-TEE during TSP using RATLe-90 maneuver is feasible with shorter fluoroscopy time and minimizing TEE probe manipulations.
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spelling doaj-art-2d9366fbf6544fa496eeac00e31962f62025-08-20T02:24:04ZengWileyCardiology Research and Practice2090-80162090-05972015-01-01201510.1155/2015/174051174051A Proposed Maneuver to Guide Transseptal Puncture Using Real-Time Three-Dimensional Transesophageal Echocardiography: Pilot StudyHani M. Mahmoud0Mohammed A. Al-Ghamdi1Abdullah E. Ghabashi2Ashraf M. Anwar3Adult Cardiology Department, Prince Sultan Cardiac Center, Al-Hassa, Saudi ArabiaAdult Cardiology Department, Prince Sultan Cardiac Center, Al-Hassa, Saudi ArabiaAdult Cardiology Department, Prince Sultan Cardiac Center, Al-Hassa, Saudi ArabiaCardiology Department, Al-Azhar University, Cairo, EgyptAim of Study. To assess the feasibility of a new proposed maneuver “RATLe-90” using real-time three-dimensional transesophageal echocardiography (RT-3DTEE) for anatomically oriented visualization of the interatrial septum (IAS) in guiding the transseptal puncture TSP. Methods. The study included 20 patients (mean age, 60.2±6.7 years; 60% males) who underwent TSP for different indications. RT-3DTEE was used to guide TSP. The proposed maneuver RATLe-90 (Rotate-Anticlockwise-Tilt-Left-90) was applied in all cases to have the anatomically oriented en face view of the IAS from the right atrial (RA) aspect. Having this anatomically oriented view, we guided the TSP catheter towards the proper puncture site according to the planned procedure. Results. Using the RATLe-90 maneuver, the anatomically oriented en face view of the IAS from the RA was obtained in all patients. We were able to guide the puncture catheter to the proper puncture site on the IAS. The 3D images obtained were clearly understood by both echocardiographers and interventionists. The RATLe-90 maneuver acquisition time was 19.9±1.6 seconds. The time-to-tent was 64.8±16.3 seconds. Less TEE probe manipulations were needed while guiding the TSP. Conclusions. Application of RT3D-TEE during TSP using RATLe-90 maneuver is feasible with shorter fluoroscopy time and minimizing TEE probe manipulations.http://dx.doi.org/10.1155/2015/174051
spellingShingle Hani M. Mahmoud
Mohammed A. Al-Ghamdi
Abdullah E. Ghabashi
Ashraf M. Anwar
A Proposed Maneuver to Guide Transseptal Puncture Using Real-Time Three-Dimensional Transesophageal Echocardiography: Pilot Study
Cardiology Research and Practice
title A Proposed Maneuver to Guide Transseptal Puncture Using Real-Time Three-Dimensional Transesophageal Echocardiography: Pilot Study
title_full A Proposed Maneuver to Guide Transseptal Puncture Using Real-Time Three-Dimensional Transesophageal Echocardiography: Pilot Study
title_fullStr A Proposed Maneuver to Guide Transseptal Puncture Using Real-Time Three-Dimensional Transesophageal Echocardiography: Pilot Study
title_full_unstemmed A Proposed Maneuver to Guide Transseptal Puncture Using Real-Time Three-Dimensional Transesophageal Echocardiography: Pilot Study
title_short A Proposed Maneuver to Guide Transseptal Puncture Using Real-Time Three-Dimensional Transesophageal Echocardiography: Pilot Study
title_sort proposed maneuver to guide transseptal puncture using real time three dimensional transesophageal echocardiography pilot study
url http://dx.doi.org/10.1155/2015/174051
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