Double-wire technique to facilitate vein of Marshall cannulation and ethanol infusion in atrial fibrillation: a case series

BMC Cardiovascular Disorders

Research

Hong-Da Zhang¹  Feng-Yuan Yu¹  Min Tang¹  Li-Jie Mi¹  Kuo Zhang¹  Lei Ding¹  Zi-Han Jiang¹  Si-Xian Weng² 

[1] Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, 167 Beilishi Road, Xicheng District, 100037, Beijing, China;National Center for Clinical Laboratories, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, National Center of Gerontology, Beijing, China;

关键词: Atrial fibrillation;    The vein of Marshall;    Ethanol infusion;    Cannulation;    Case report;   

DOI  :  10.1186/s12872-023-03553-9

 received in 2023-05-03, accepted in 2023-10-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe vein of Marshall (VOM) ethanol infusion is increasingly performed in combination with catheter ablation in atrial fibrillation (AF). The cannulation of the VOM can sometimes be challenging. This study aimed to evaluate the double-wire technique in cases of difficult cannulation of the VOM.Case presentationPatients with AF scheduled for combined catheter ablation and VOM ethanol infusion were consecutively enrolled. The procedure was performed via the femoral vein. If the regular cannulation technique with one angioplasty wire failed or took more than 20 min, the double-wire technique using a stabilizing wire and a cannulation wire was performed. The unique technique was used mainly in two scenarios, when the Eustachian ridge was too prominent as a barrier for catheter manipulation or when the VOM ostium was close to the coronary sinus ostium. Of 162 patients scheduled for VOM ethanol infusion, the double-wire technique was applied in 6 (3.7%) patients and led to a 100% successful cannulation rate of the VOM. Of the six patients, two had a prominent Eustachian ridge, and four had a VOM ostium close to the coronary sinus ostium. The mean cannulation time was 33.3 ± 7.3 min. The ethanol infusion was successfully performed in 5 patients. One patient had a collateral circulation in the distal VOM, and ethanol infusion was not performed.ConclusionsThe double-wire technique can facilitate VOM cannulation and ethanol infusion in challenging cases.Word count: 231.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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