Additional use of Outer-Cath for LV-LP guided by Inner-Cath
In the Inner-Cath group, most of the LV-LPs were successfully guided by Inner-Cath alone except for 2 patients, who required additional use of an Outer-Cath for CS cannulation of the guiding sheath due to marked enlargement of the right atrium. Preprocedural CT or MRI images may be useful to assess not only the anatomy of the CS trunk and tributaries but also those of both atria, predicting difficult cases of LV-LP guided by Inner-Cath alone.