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. 2023 Oct 19;39(6):963-964.
doi: 10.1002/joa3.12943. eCollection 2023 Dec.

Solving difficulties in transseptal sheath crossing: The shoehorn technique

Juan Benezet-Mazuecos  1 , Álvaro Lozano  1 , Julián Crosa  1 , Ángel Miracle  1
Affiliations

Solving difficulties in transseptal sheath crossing: The shoehorn technique

Juan Benezet-Mazuecos et al. J Arrhythm. .

Abstract

The shoehorn technique is a simple and safe maneuver that can help to solve difficulties in challenging transseptal sheath crossing for atrial fibrillation cryoablation procedures.

Keywords: atrial fibrillation; cryoablation; transseptal puncture.

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Conflict of interest statement

Authors declare no conflict of interests for this article.

Figures

FIGURE 1
FIGURE 1
The shoehorn technique. (A) Left anterior oblique fluoroscopic projection showing a tetrapolar electrode catheter placed in the right subclavian vein for phrenic nerve stimulation and the 12F FlexCath AdvanceTM Steerable Sheath showing difficulties for transseptal crossing over a wire placed in the left superior PV. (B) The tetrapolar electrode catheter is introduced then into the LA through the transseptal puncture hole. The shoehorn technique consists of removing back the tetrapolar electrode catheter while we try to progress forward the sheath over the wire placed in the left superior PV. (C) The sheath cross safely the transseptal puncture once the tetrapolar electrode is removed back into the right atrium. LA, left atrium; PV, pulmonary veins.
See this image and copyright information in PMC

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