ArticleFrontiers in cardiovascular medicine2026
Clinical application of the transseptal puncture technique using a biplane positioning method with left atrial 3D-CT.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Case report: A unified CTA-fluoroscopy roadmap for single-session pulsed field ablation and left atrial appendage occlusion.Frontiers in cardiovascular medicine · 2026Article
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6 authors.
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Abstract
Introduction: Traditional transseptal puncture (TSP) relies on x-ray imaging and anatomical landmarks, which poses challenges in patients with atrial structural variations or overweight. Furthermore, emerging interventional techniques demand precise puncture site localization. This feasibility study evaluates the safety and efficacy of a novel biplane positioning method guided by left atrial (LA) 3D-CT reconstruction for TSP. Methods: A retrospective analysis included 100 atrial fibrillation patients undergoing radiofrequency catheter ablation (RFCA) between July 2023 and March 2024. Preoperative LA-enhanced CT scans were performed to reconstruct 3D models. Key measurements included vertebral height (H), horizontal distance (X) from the target puncture point (O) to the anterior spine edge at 45° right anterior oblique (RAO) view, and vertical distance (Y) between O and the great cardiac vein. Intraoperative biplane localization integrated CT-derived ratios (X/H, Y/H) with fluoroscopy. Statistical analyses compared outcomes across LA size subgroups. Results: All patients achieved successful TSP without complications (e.g., cardiac tamponade, thromboembolism). The mean X/H and Y/H ratios were 0.8 ± 0.2 and 0.5 ± 0.1, respectively. Patients with larger LA diameters (≥50 mm) exhibited significantly greater X values (16.8 ± 3.3 mm vs. 13.6 ± 4.2 mm, Discussion: The LA 3D-CT-guided biplane positioning method demonstrates feasibility, accuracy, and safety for TSP in atrial fibrillation patients, including those with enlarged atria, structural anomalies, or overweight. The protocol is feasible within a limited, single-center cohort.
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