Use of a novel integrated dilator-needle system for trans-septal puncture in three dogs undergoing left atrial decompression.

Left atrial decompression (LADEC) is an emerging palliative intervention for dogs with advanced left-sided congestive heart failure. Trans-septal puncture is a critical step of this procedure and is traditionally performed using Brockenbrough-style needles with multiple device exchanges. A novel integrated dilator-needle system (FlexCath Cross™, Medtronic) has been developed in human cardiology to allow a zero-exchange approach to trans-septal puncture; however, its use in veterinary patients has not previously been described. This report describes the technical feasibility of using this integrated system for trans-septal access in three dogs undergoing LADEC for congestive heart failure secondary to myxomatous mitral valve disease. In three cases, trans-septal access was successfully achieved using the integrated dilator-needle system, allowing completion of the planned LADEC procedure. No major device-related complications were observed. These cases demonstrate the feasibility of this alternative trans-septal access technique in selected canine patients.