Transhepatic access to the atrioventricular ring for delivery of radiofrequency energy.
BACKGROUND
Transcatheter radiofrequency ablation is an effective, safe treatment of arrhythmias in children. However, despite technical advances, patients with obstructed venous access to the heart have not been candidates for this treatment.


RESULTS
Two children (8.2 and 10.9 kg) with complex congenital heart disease, supraventricular tachycardia, and obstructed venous access underwent successful radiofrequency ablation of either a right (one patient) or left (one patient) accessory pathway using the transhepatic route to the heart.


CONCLUSIONS
This experience underscores the usefulness of the transhepatic approach in small patients, in patients with limited venous access, and in patients with complex congenital heart disease.
Fischbach
P
P
Michigan Congenital Heart Center, C.S. Mott Children's Hospital, Department of Pediatrics, University of Michigan, Ann Arbor, USA.
Campbell
R M
RM
Hulse
E
E
Mosca
R
R
Armstrong
B
B
Lloyd
T R
TR
Dick
M
M
D001157:Arterial Occlusive Diseases / Q000150:complications / Q000601:surgery; D002036:Bundle of His / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery; D006801:Humans; D007223:Infant; D008099:Liver / Q000601:surgery*; D008297:Male; D013617:Tachycardia, Supraventricular / Q000209:etiology / Q000601:surgery