COMPARISON OF TRANSSEPTAL PUNCTURE AND PFO ROUTE FOR LEFT-SIDED ACCESSORY PATHWAY ABLATION IN PEDIATRIC PATIENTS

Tolunoglu A., Sülü A., Kafali H. C., Cınar B., Guzeltas A., Ergul Y.

AEPC 2022 - 55th Annual Meeting of the Association for European Paediatric and Congenital Cardiology , Geneve, İsviçre, 25 - 28 Mayıs 2022, ss.492

  • Yayın Türü: Bildiri / Tam Metin Bildiri
  • Basıldığı Şehir: Geneve
  • Basıldığı Ülke: İsviçre
  • Sayfa Sayıları: ss.492
  • Eskişehir Osmangazi Üniversitesi Adresli: Evet

Özet

492

P-255

Arrhythmia / Electrophysiology

COMPARISON OF TRANSSEPTAL PUNCTURE AND PFO ROUTE FOR LEFT-SIDED ACCESSORY

PATHWAY ABLATION IN PEDIATRIC PATIENTS

Aras Tulunoglu, Hasan Candas Kafali, Ayse Sulu, Betul Cinar, Alper Guzeltas, Yakup Ergul

Department of Pediatric Cardiology, Saglik Bilimleri University M. Akif Ersoy Thoracic and

Cardiovascular Surgery Center, Istanbul, Turkey

BACKGROUND AND AIM: Antegrade or retrograde approaches can be used for left sided accessory

pathway (AP) ablation. Because of the important arterial complications related to puncture in

retrograde approach, some experienced centers prefer to access the left atrium via patent foramen

ovale (PFO) or transseptal puncture (TSP). In this study we share our experience with TSP and to

compare it with PFO.

METHODS: We compare single center data of 322 pediatric patients with left-sided accessory

pathway (AP), between 2013 and 2021. Antegrade approach (TSP or PFO) was preferred in all

patients. Type of AP, duration of procedure, fluoroscopy time, success, recurrence and complications

were compared. Fluoroscopy was used in addition to 3D mapping system in all cases.

RESULTS: The ablation procedures were performed via TSP in 233(72.3%) cases and PFO in 89(27.7%)

cases. In both groups, 196(60.9%) of the patients were male. Median age and weight in TSP group

were 12.55±3.73 years and 49.36±19.14 kilograms. Median age and weight in PFO group were

11.26±4.79 years and 45.07±21.42 kilograms. In total, 205(64%) of the patients had manifest,

117(36%) of them had concealed AP. All TSP procedures were performed successfully, and no major

complications were observed, except for one self-limiting pericardial effusion. The most common AP

locations were lateral in 111(%34.4) cases and posterolateral in 80(24.8%) cases. The mean

procedural duration was 141.2±51.69 minutes in TSP cases, and 138.1±52.18 minutes in PFO cases.

Mean fluoroscopy duration was 3.99±3.91minutes in TSP cases and 1.54±3.27minutes in PFO cases.

Number of procedures that considered unsuccessful is 4 in each group (success rate was 98% in TSP

and %95.5 in PFO groups). In follow-ups, recurrence was observed in 7 (3%) TSP and 7 (7.8%) PFO

cases. When both groups were compared, no statistically significant difference was found between

the success(p=0.228), complication(p=0.328) and recurrence rates(p=0.073) and procedural

time(p=0.463); but the fluoroscopy time was found shorter in PFO group (p<0.0001) as expected.

CONCLUSIONS: Left-sided AP ablation in children can be performed safely via TSP or through PFO in

experienced centers. The presence of PFO had no effect on procedure time, success and recurrence

rates; but the fluoroscopy time predicted to be slightly shorter.