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

Journal of Interventional Cardiology
Stefan BuchnerAndreas Luchner

Abstract

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. 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. 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. 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 f...Continue Reading

References

Dec 25, 2008·Circulation·Masakiyo NobuyoshiHideyuki Nosaka
Jan 22, 2011·JACC. Cardiovascular Interventions·Paul T L Chiam, Carlos E Ruiz
Apr 16, 2011·Journal of the American College of Cardiology·Robert J SiegelUNKNOWN EVEREST Investigators
Nov 15, 2011·Journal of the American College of Cardiology·Volker RudolphStephan Baldus
Jul 19, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hermann ReichenspurnerUNKNOWN ACCESS-EU Phase I Investigators
Mar 4, 2014·Journal of the American College of Cardiology·Ted Feldman, Amelia Young

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