title: Transhepatic access to the atrioventricular ring for delivery of radiofrequency energy.
abstract: 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.
authors.affiliation: Michigan Congenital Heart Center, C.S. Mott Children's Hospital, Department of Pediatrics, University of Michigan, Ann Arbor, USA.
authors.forename: P
authors.initials: P
authors.lastname: Fischbach
authors.forename: R M
authors.initials: RM
authors.lastname: Campbell
authors.forename: E
authors.initials: E
authors.lastname: Hulse
authors.forename: R
authors.initials: R
authors.lastname: Mosca
authors.forename: B
authors.initials: B
authors.lastname: Armstrong
authors.forename: T R
authors.initials: TR
authors.lastname: Lloyd
authors.forename: M
authors.initials: M
authors.lastname: Dick
mesh_terms: 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