Trans–right atrial access to the left ventricle for catheter ablation of ventricular tachycardia in a patient with double left-sided mechanical valves: First case report from Latin America

Patients with combined mechanical aortic and mitral valve prostheses pose a unique challenge for catheter ablation of arrhythmias arising from the left ventricle (LV), as the traditional access routes are rendered impossible. Therefore, unconventional strategies like epicardial access, transcoronary venous catheterization, surgical transapical access or intentional septal defects, have been explored. Santangeli et al. developed a percutaneous technique from the right atrium (RA) through the inferoseptal process (ISP), mirroring a Gerbode defect, and allowincg catheter access for endocardial VT ablation.