Guide Wire Entrapment in Mitral Subvalvular Apparatus during Left Lateral Accessory Pathway Ablation: A Case Report

Abstract

Mitral annular region and valvular apparatus injury during catheter ablation is a rare but serious complication. Although entrapment of a circular-tip mapping catheter in the mitral valve complex has been described as a major etiology of this rare complication, spring-tip guide wire entrapment in mitral valve complex during ablation procedures is unreported. We reported entrapment of a spring-tip guide wire in the mitral subvalvular apparatus during ablation of left lateral accessory pathway using transatrial septal approach. Various techniques were performed to make the guide wire free, which ultimately resulted in fracture of its distal end and subsequently surgical extraction. This unusual complication of catheter ablation would be a critical harm to patients undergoing trans-septal ablation approaches and great consideration should be warranted during the procedures.