title: Difficult case of a trans-septal puncture: Use of a "SafeSept" guidewire.
abstract: A 69-year-old man was admitted to our center to undergo catheter ablation of paroxysmal atrial fibrillation refractory to antiarrhythmic drug therapy. This procedure required access to the left atrium through the interatrial septum. During hospitalization, the patient performed routinely pre-procedure transthoracic echocardiography and gadolinium-enhanced cardiac magnetic resonance showing a normal anatomy of both the fossa ovalis and the interatrial septum. Access to the left atrium proved difficult and several unsuccessful attempts to perform the trans-septal puncture were made under both fluoroscopy and intracardiac echocardiography guidance, even with radiofrequency energy delivery. Finally, trans-septal puncture was successfully carried out using a novel nitinol J-shaped "SafeSept" trans-septal guidewire, designed to cross the interatrial septum through the trans-septal needle thanks to a special sharp tip. Moreover, thanks to its rounded J shape that reduces the risk of atrial perforation, the "SafeSept" guidewire, when advanced into the left atrium, becomes atraumatic.
authors: Martina Zucchetti, Michela Casella, Antonio Dello Russo, Gaetano Fassini, Corrado Carbucicchio, Eleonora Russo, Vittoria Marino, Valentina Catto, Claudio Tondo, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy.
authors: Martina
authors: M
authors: Zucchetti
authors: Martina Zucchetti, Michela Casella, Antonio Dello Russo, Gaetano Fassini, Corrado Carbucicchio, Eleonora Russo, Vittoria Marino, Valentina Catto, Claudio Tondo, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy.
authors: Michela
authors: M
authors: Casella
authors: Martina Zucchetti, Michela Casella, Antonio Dello Russo, Gaetano Fassini, Corrado Carbucicchio, Eleonora Russo, Vittoria Marino, Valentina Catto, Claudio Tondo, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy.
authors: Antonio
authors: A
authors: DelloRusso
authors: Martina Zucchetti, Michela Casella, Antonio Dello Russo, Gaetano Fassini, Corrado Carbucicchio, Eleonora Russo, Vittoria Marino, Valentina Catto, Claudio Tondo, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy.
authors: Gaetano
authors: G
authors: Fassini
authors: Martina Zucchetti, Michela Casella, Antonio Dello Russo, Gaetano Fassini, Corrado Carbucicchio, Eleonora Russo, Vittoria Marino, Valentina Catto, Claudio Tondo, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy.
authors: Corrado
authors: C
authors: Carbucicchio
authors: Martina Zucchetti, Michela Casella, Antonio Dello Russo, Gaetano Fassini, Corrado Carbucicchio, Eleonora Russo, Vittoria Marino, Valentina Catto, Claudio Tondo, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy.
authors: Eleonora
authors: E
authors: Russo
authors: Martina Zucchetti, Michela Casella, Antonio Dello Russo, Gaetano Fassini, Corrado Carbucicchio, Eleonora Russo, Vittoria Marino, Valentina Catto, Claudio Tondo, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy.
authors: Vittoria
authors: V
authors: Marino
authors: Martina Zucchetti, Michela Casella, Antonio Dello Russo, Gaetano Fassini, Corrado Carbucicchio, Eleonora Russo, Vittoria Marino, Valentina Catto, Claudio Tondo, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy.
authors: Valentina
authors: V
authors: Catto
authors: Martina Zucchetti, Michela Casella, Antonio Dello Russo, Gaetano Fassini, Corrado Carbucicchio, Eleonora Russo, Vittoria Marino, Valentina Catto, Claudio Tondo, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy.
authors: Claudio
authors: C
authors: Tondo
keywords: Atrial fibrillation; Interatrial septum; Intracardiac echocardiography; Trans-septal puncture; “SafeSept” guidewire