Residual Iatrogenic Gerbode Defect After Direct Puncture and Balloon Dilation of the Inferior-Septal Process of the Left Ventricle (ISP-LV)

In patients with combined mitral and aortic mechanical values and recurrent ventricular tachycardia (VT) related to diseased left ventricular (LV) substrate, traditional retrograde aortic or antegrade transmitral LV access approaches for catheter ablation are impossible. Researchers have developed a novel technique to access the LV via direct puncture of the ISP-LV from the adjacent right atrium (RA) in these patients. This video provides an intracardiac echography view of the Gerbode defect, defined as an LV-RA shunt, that is the iatrogenic residual of the procedure after the catheter ablation and after the deflectable sheath and ablation catheter have been withdrawn into the RA. Click the Related Article link for complete details of the procedure and outcomes in a case series of patients and related video links for illustrations of steps of the technique.