Background: SVT occur after an extrcardiac Fontan (EFs) and are difficult to treat using catheter ablation (CA) because of the access. There are a few reports on performing conduit punctures (CPs), but it is difficult to stabilize the tip of the needle during the puncture. We developed a new procedure for CPs using a snare catheter.
Case Report: One 15-year-old patient with tachycardias associated with an accessory pathway and twin AVNs underwent an EF using GORE-TEX® for right isomerism heart and atrioventricular septal defect. Another 15-year-old patient with an accessory pathway underwent an EF for mitral atresia. Two patients underwent CA via a CP with a snare catheter. The tip of the dilator of a long sheath was grasped with a snare in order to prevent the tip of the needle from slipping. Then a BRK needle was advanced from within the dilator of the sheath to the atrium under fluoroscopy or intracardiac echocardiography guidance. The CA procedures were successful without any complications.
Conclusions: CA of SVTs after an EF could safely and successfully be ablated via a CP utilizing a snare catheter.