title: Transesophageal echocardiographically guided atrial transseptal catheterization in patients with normal-sized atria: incidence of complications.
abstract: The incidence of cardiac complications from atrial transseptal catheterization has never been quantified in patients with normal-sized atria. Series defining the complication rate are derived from diseased hearts with structural changes that may alter the complication rate of the procedure. The generation of a standardized incidence of perforation in a population of structurally normal atria has important implications. A total of 46 atrial transseptal catheterizations guided by transesophageal echocardiography (TEE) for radiofrequency ablation of left-sided accessory pathways was performed in 42 patients during a 3-year period (1990-1993). Clinical and echocardiographic data were analyzed, with special attention given to TEE reports pre- and post-transseptal catheterization. Only one complication occurred in the 46 procedures (2.2%): a perforation of the left atrium that led to pericardial effusion and cardiac tamponade. In a small series of patients with normal sized atria, we have demonstrated that TEE-guided transseptal catheterization in a procedure with a low complication rate.
authors.affiliation: University of Wisconsin Medical School, Milwaukee Heart Institute of Sinai Samaritan Medical Center, Milwaukee 53233, USA.
authors.forename: K
authors.initials: K
authors.lastname: Hahn
authors.forename: R
authors.initials: R
authors.lastname: Gal
authors.forename: J
authors.initials: J
authors.lastname: Sarnoski
authors.forename: J
authors.initials: J
authors.lastname: Kubota
authors.forename: D H
authors.initials: DH
authors.lastname: Schmidt
authors.forename: T K
authors.initials: TK
authors.lastname: Bajwa
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000379:methods*; D016022:Case-Control Studies; D017115:Catheter Ablation; D017548:Echocardiography, Transesophageal; D005260:Female; D006325:Heart Atria; D006329:Heart Conduction System / Q000002:abnormalities / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged