{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T12:23:34Z","timestamp":1784291014660,"version":"3.55.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T00:00:00Z","timestamp":1552953600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Inadvertent puncture of the aortic root (AR) is a well-known complication of transseptal puncture (TSP). Strategies for handling of this potentially lethal complication have not been identified yet. In this study, we present typical anatomical locations and clinical management of aortic root puncture (ARP) due to TSP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>All patients with ARP were retrospectively collected from seven hospitals. Aortic root puncture was identified and classified regarding angiographical and intraoperative findings in cardiac surgery: (i) TSP from the right atrium (RA) to the non-coronary sinus (NCS), (ii) TSP from RA to the non-coronary sinutubular junction (STJ), and (iii) TSP from RA to the ascending aorta (AA). A total of 24 patients with inadvertent ARP were identified. In 19 patients, penetration of the aorta was accomplished by the inner dilator, in 5 patients by the complete sheath. Previous cardiac surgery had been performed in six patients. There were 13 RA-to-NCS punctures, 2 RA-to-STJ punctures, and 9 RA-to-AA punctures. No cardiac tamponade (CT) occurred in patients with RA-to-NCS and RA-to-STJ punctures. In 8 of 9 patients with RA-to-AA puncture, CT occurred immediately requiring urgent pericardiocentesis and surgical repair. Two patients died after surgical repair. In the 16 patients without surgical therapy, no shunt from the AR to the RA was observed 3\u2009months after the procedure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Aortic root puncture due to mislead TSP via NCS or STJ is usually not associated with a severe clinical course while ARP into the AA via the epicardial space generally leads to CT requiring surgical repair.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euz042","type":"journal-article","created":{"date-parts":[[2019,3,12]],"date-time":"2019-03-12T20:12:56Z","timestamp":1552421576000},"page":"1106-1115","source":"Crossref","is-referenced-by-count":26,"title":["Inadvertent transseptal puncture into the aortic root: the narrow edge between luck and catastrophe in interventional cardiology"],"prefix":"10.1093","volume":"21","author":[{"given":"Hao","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Asklepios Klinik St. Georg, Lohm\u00fchlenstr. 5, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Fink","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asklepios Klinik St. Georg, Lohm\u00fchlenstr. 5, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianzhang","family":"Zhan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minglong","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Eckardt","sequence":"additional","affiliation":[{"name":"Department of Cardiology-Electrophysiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deyong","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Ma","sequence":"additional","affiliation":[{"name":"Center of Cardiac Arrhythmias, Fuwai Hospital of the Chinese Academy of Medical Sciences, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Rosso","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tel-Aviv Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shibu","family":"Mathew","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asklepios Klinik St. Georg, Lohm\u00fchlenstr. 5, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumei","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weizu","family":"Ju","sequence":"additional","affiliation":[{"name":"Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Wasmer","sequence":"additional","affiliation":[{"name":"Department of Cardiology-Electrophysiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changsheng","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiandu","family":"Yang","sequence":"additional","affiliation":[{"name":"Center of Cardiac Arrhythmias, Fuwai Hospital of the Chinese Academy of Medical Sciences, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilman","family":"Maurer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asklepios Klinik St. Georg, Lohm\u00fchlenstr. 5, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian-Hendrik","family":"Heeger","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asklepios Klinik St. Georg, Lohm\u00fchlenstr. 5, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siew Yen","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Royal Brompton Hospital and Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl-Heinz","family":"Kuck","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asklepios Klinik St. Georg, Lohm\u00fchlenstr. 5, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shulin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feifan","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asklepios Klinik St. Georg, Lohm\u00fchlenstr. 5, Hamburg, Germany"},{"name":"Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,3,18]]},"reference":[{"key":"2019071004555745400_euz042-B1","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1136\/hrt.26.4.460","article-title":"Combined percutaneous retrograde aorta and transseptal left heart catheterization","volume":"26","author":"Peckham","year":"1964","journal-title":"Br Heart J"},{"key":"2019071004555745400_euz042-B2","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/BF02242264","article-title":"Transseptal left heart catheterization: experience with a new technique in 520 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