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Case Reports
. 2010 Mar;7(3):413-6.
doi: 10.1016/j.hrthm.2009.10.037. Epub 2009 Nov 10.

Transconduit puncture for catheter ablation of atrial tachycardia in a patient with extracardiac Fontan palliation

Amish S Dave  1 , Jamil Aboulhosn, John S Child, Kalyanam Shivkumar
Affiliations
Case Reports

Transconduit puncture for catheter ablation of atrial tachycardia in a patient with extracardiac Fontan palliation

Amish S Dave et al. Heart Rhythm. 2010 Mar.
No abstract available

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Figures

Figure 1
Figure 1. Rendering of post-surgical anatomy
There is tricuspid valve atresia with hypoplastic right ventricle and well-developed systemic left ventricle (LV). Great arteries are D-transposed with the aorta (Ao) anteriorly dextraposed and the banded pulmonary artery (PA) posteriorly levoposed. Superior vena cava (SVC) is connected to PA via bidirectional Glenn shunt. Extracardiac conduit connects inferior vena cava to PA. Note close proximity of extracardiac conduit to “right atrial” portion (RA) of pulmonary venous atrium. The “left atrium” (LA) and mitral valve (MV) are labeled.
Figure 2
Figure 2
Fluoroscopic images showing (A) still-frame from conduit angiogram, (B) transseptal needle with contrast staining of conduit prior to crossing, (C) dilator of transseptal sheath crossing conduit into pulmonary venous atrium, (D) Toray valvuloplasty wire coiled in atrium with angioplasty balloon inflated across conduit crossing, and (E) still-frame from angiography of pulmonary venous atrium.
Figure 3
Figure 3
(A) ECG tracings of the atrial tachycardia. (B) Catheter positions in LAO at ablation site (Abl) along anterior border of atrio-ventricular (mitral) valve. A duodecapolar catheter (Ao) crosses aortic valve into LV. (C) Electroanatomic voltage map of pulmonary venous atrium is shown on right with healthy atrial tissue in purple and a scar visible on this anterolateral view. Extracardiac conduit tube is in beige. Solid black line marks approximate location of mitral valve. Voltages below 0.05V were mapped to gray, between 0.05V and 0.5V to colors between red and purple, and above 0.5V to purple.
See this image and copyright information in PMC

References

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    1. AboulHosn JA, Shavelle DM, Castellon Y, et al. Fontan operation and the single ventricle. Congenit Heart Dis. 2007;2(1):2–11. - PubMed
    1. Aboulhosn J, Child JS. The adult with a Fontan operation. Curr Cardiol Rep. 2007;9(4):331–335. - PubMed

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