Transseptal catheterization without needle puncture.
OBJECTIVE
The aim was to see if probing the fossa ovalis for transseptal puncture during balloon mitral valvuloplasty will reduce time consumed for the procedure.


METHODS
Twenty-five patients had probing of fossa ovalis for left atrial entry (group I). In 30 patients (group II), standard needle puncture was done for left atrial entry. Puncture time and fluoroscopy time were noted and oxymetry was done. Later, a further 60 patients underwent probing of fossa ovalis for validation of the technique.


RESULTS
Puncture times in groups I and II were 84.7 +/- 27.5 and 116.1 +/- 37.9 s, respectively (p < 0.02). Fluoroscopy time was 51.2 +/- 19.6 and 73.6 +/- 22.3 s in groups I and II, respectively (p < 0.03). During validation of the technique, 54 of 60 patients (90%) had successful left atrial entry through probing. Atrial level shunt was not seen.


CONCLUSIONS
Probing the fossa achieves left atrial entry in 90% of patients. It avoids needle puncture and reduces puncture time as well as fluoroscopy time. It is a safe technique.
Krishnamoorthy
K M
KM
Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India. saikm@sctimst.ker.nic.in
Dash
P K
PK
D000293:Adolescent; D000328:Adult; D002404:Catheterization / Q000379:methods*; D005260:Female; D006346:Heart Septum / Q000601:surgery*; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000601:surgery*; D009339:Needles; D011677:Punctures