Dong ZY, Shao W, Yuan Y, Lin L, Yu X, Cui L, Zhen Z, Gao L. Transseptal approach for catheter ablation of left-sided accessory pathways in children with Marfan syndrome: A case report. World J Clin Cases 2023; 11(9): 2084-2090 [PMID: 36998966 DOI: 10.12998/wjcc.v11.i9.2084]
Corresponding Author of This Article
Lu Gao, MD, Chief Physician, National Center for Children’s Health, Beijing Children's Hospital, Capital Medical University, No. 56 South Lish Road, Beijing 100045, China. gaoluga33400122@163.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 26, 2023; 11(9): 2084-2090 Published online Mar 26, 2023. doi: 10.12998/wjcc.v11.i9.2084
Transseptal approach for catheter ablation of left-sided accessory pathways in children with Marfan syndrome: A case report
Zi-Yan Dong, Wei Shao, Yue Yuan, Li Lin, Xia Yu, Lang Cui, Zhen Zhen, Lu Gao
Zi-Yan Dong, Wei Shao, Yue Yuan, Li Lin, Xia Yu, Lang Cui, Zhen Zhen, Department of Cardiology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
Lu Gao, National Center for Children’s Health, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
Author contributions: Dong ZY and Shao W designed the study; Dong ZY wrote the original manuscript; Shao W, Yuan Y, Yu X, Cui L, Zhen Z, Gao L reviewed and revised the manuscript; All authors have read and approve the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lu Gao, MD, Chief Physician, National Center for Children’s Health, Beijing Children's Hospital, Capital Medical University, No. 56 South Lish Road, Beijing 100045, China. gaoluga33400122@163.com
Received: December 28, 2022 Peer-review started: December 28, 2022 First decision: February 8, 2023 Revised: February 20, 2023 Accepted: March 3, 2023 Article in press: March 3, 2023 Published online: March 26, 2023
Abstract
BACKGROUND
Left-sided accessory pathways (APs) can be accessed with either a transaortic (TA) or transseptal approach (TS). For children with Marfan syndrome (MFS) who have aortic disease, the use of TA can aggravate the disease, making TS the best choice for these patients.
CASE SUMMARY
A 10-year-old girl was hospitalized because of intermittent heart palpitations and chest tightness. She was diagnosed with MFS, supraventricular tachycardia, Wolff-Parkinson-White syndrome, and left-sided AP was detected by cardiac electrophysiological. Catheter ablation was successfully performed via TS under the guidance of the Ensite system. During the follow-up, no recurrence or complications occurred.
CONCLUSION
The TS for catheter ablation of left-sided APs can be considered in children with MFS. Adequate evaluation and selection of the appropriate puncture site are particularly important.
Core Tip: Left-sided accessory pathways (APs) can be accessed with either a transseptal (TS) or transaortic approach (TA). For children with Marfan syndrome (MFS) who have aortic disease, however, the use of TA can aggravate the disease. We report a case of successful catheter ablation of the left-sided accessory pathway by TS in one such child. The TS approach for catheter ablation of left-sided APs appears to be a safe and effective therapeutic option applicable in older children with MFS, though it requires a certain level of training and experience to perform.
