Conquest Pro 12 coronary guidewire for perforation of functionally interrupted aorta.

We read an article by Alwi et al 1 entitled ''Pulmonary atresia with intact septum: the use of Conquest Pro coronary guidewire for perforation of atretic valve and subsequent interventions'' with deep interest. It is important to mention that guidewires used in chronic total occlusion treatment such as Conquest Pro are often used by adult cardiologists, but are not used in paediatric cardiology because of not being known or because of limited areas of usage. The guidewires used in chronic total occlusion differ from other guidewires in that they have heavy tips. They are placed into an exact area where they are desired to be perforated and then they are pushed gently, which is sufficient to have successful results. In the following extract, we would like to share our experience with Conquest Pro 12, which we used successfully during transcatheter operation in a patient detected with functionally interrupted aorta. A 21-year-old female patient was referred to our hospital as she had been diagnosed with interrupted aorta while having been tested for hypertension. A computer tomography scan detected a 3-mm membranous-type interruption at 1 cm distal to the left subclavian artery, and thus transcatheter intervention was scheduled (Fig 1). The various guidewires that were sent from the sheath placed in the left radial artery could not pass the atretic portion, despite the sharp edges of these guide-wires. Radiofrequency perforation (HAT 300 generator and 0.018-in. cereblate wire (Sulzer Osypka GmBH, Grenzach-Wyhlen, Germany)) was tried by giving energy up to 20 W in order to perforate the atretic portion; however, this was not achieved. On the contrary, a positive result was obtained when the Conquest Pro 12 (Asahi Intecc Co. Ltd, Aichi, Japan) guidewire perforation procedure was performed. During the first trial, the guidewire was pulled back when it was realised that the wire had advanced subintimally, and only after repeating the procedure did it enter the exact lumen. A loop was formed between the left radial artery and the left femoral artery. Once pre-dilatation had been done, first by 4 mm 3 2 cm coronary balloon and later by 7 mm 3 2 cm Tyshak Balloon (Numed Canada Incorporation, Cornwall, Ontario, Canada) and lumen was generated, 39 mm coated CP stent was placed there with standard technique. Continuity in the aorta was provided as the atretic part was opened (Figs 1 and 2). In the case described above, unlike Alwi et al, …