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Case Reports
. 2017 Oct 25:2017:bcr2017221338.
doi: 10.1136/bcr-2017-221338.

Circular mapping catheter entrapment in mitral valve apparatus requiring emergency surgery: a rarely reported complication of pulmonary vein isolation procedure for atrial fibrillation

Muhammad Iftikhar Sabar  1 , Abhay Bajpai  2   3 , Aziz Momin  3 , Riyaz A Kaba  1   3
Affiliations
Case Reports

Circular mapping catheter entrapment in mitral valve apparatus requiring emergency surgery: a rarely reported complication of pulmonary vein isolation procedure for atrial fibrillation

Muhammad Iftikhar Sabar et al. BMJ Case Rep. .

Abstract

Lasso catheter (Biosense Webster) is one of the most commonly employed circular mapping catheters during pulmonary vein isolation (PVI) procedure for atrial fibrillation (AF). Although this catheter has greatly facilitated arrhythmia mapping, it can be associated with serious complications. We report a case of a 59-year-old man who underwent PVI procedure for persistent AF. During the procedure, the Lasso catheter inadvertently slipped into the left ventricular cavity and entangled in the mitral valve apparatus. Various percutaneous manoeuvres to release the catheter were unsuccessful and the patient ultimately required emergency open heart surgery to remove the catheter and repair the valve. To the best of our knowledge, such a case has not previously been reported in the UK necessitating an immediate open heart surgery, avoiding replacement of the valve.

Keywords: arrhythmias; pacing and electrophysiology; valvar diseases.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Displaced Lasso catheter from its original position in the left atrium into the left ventricle (LV) and entrapment in the mitral valve (MV) apparatus. Red dotted circle indicates the approximate desired position, whereas the white line indicates displacement into the LV. ((A) transoesophageal echocardiogram probe, (B) Lasso catheter entrapped in MV apparatus, (C) ablation catheter, (D) diagnostic decapolar catheter).
See this image and copyright information in PMC

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