Direct hepatic vein puncture and transseptal access for atrial flutter and fibrillation ablation in a patient with prior ligation of the inferior vena cava

• Prakash Goutham Suryanarayana, MD,
• Michael Ayers, MD,
• Scott O. Trerotola, MD,
• Saman Nazarian, MD, PhD, FHRS

Affiliations

Prakash Goutham Suryanarayana, MD

Cardiac Electrophysiology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

Michael Ayers, MD

Cardiovascular Medicine, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

Scott O. Trerotola, MD

Interventional Radiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

Saman Nazarian, MD, PhD, FHRS

Cardiac Electrophysiology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Address reprint requests and correspondence: Dr Saman Nazarian, Cardiac Electrophysiology, University of Pennsylvania, 3400 Spruce Street, Founders 9118, Philadelphia, PA 19104.