Published online Mar 26, 2023. doi: 10.12998/wjcc.v11.i9.2084
Peer-review started: December 28, 2022
First decision: February 8, 2023
Revised: February 20, 2023
Accepted: March 3, 2023
Article in press: March 3, 2023
Published online: March 26, 2023
Processing time: 79 Days and 9.2 Hours
Left-sided accessory pathways (APs) can be accessed with either a transaortic (TA) or transseptal approach (TS). For children with Marfan syndrome (MFS) who have aortic disease, the use of TA can aggravate the disease, making TS the best choice for these patients.
A 10-year-old girl was hospitalized because of intermittent heart palpitations and chest tightness. She was diagnosed with MFS, supraventricular tachycardia, Wolff-Parkinson-White syndrome, and left-sided AP was detected by cardiac electrophysiological. Catheter ablation was successfully performed via TS under the guidance of the Ensite system. During the follow-up, no recurrence or complications occurred.
The TS for catheter ablation of left-sided APs can be considered in children with MFS. Adequate evaluation and selection of the appropriate puncture site are particularly important.
Core Tip: Left-sided accessory pathways (APs) can be accessed with either a transseptal (TS) or transaortic approach (TA). For children with Marfan syndrome (MFS) who have aortic disease, however, the use of TA can aggravate the disease. We report a case of successful catheter ablation of the left-sided accessory pathway by TS in one such child. The TS approach for catheter ablation of left-sided APs appears to be a safe and effective therapeutic option applicable in older children with MFS, though it requires a certain level of training and experience to perform.