title: A new approach for transseptal catheterization in patients undergoing percutaneous balloon mitral valvuloplasty.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of a new approach for transseptal catheterization in patients undergoing percutaneous balloon mitral valvuloplasty (PBMV).
  
  
  METHODS
  One hundred and two patients with rheumatic mitral stenosis were randomized into two groups. In the study group (RA approach), an imaginary horizontal line was drawn from the top end of the tricuspid valve under anteroposterior fluoroscopic view. The intersection of the horizontal line and the right edge of the corresponding thoracic vertebra was defined as the upper border of the Fossa ovalis. The atrial septum was punctured from a point 0.5 cm below the upper border of the Fossa ovalis. In the control group (LA approach), an imaginary horizontal line was drawn between the upper and middle third of the left atrium, and the intersection of this horizontal line and the right edge of the corresponding thoracic vertebra was used as an atrial septum puncture point.
  
  
  RESULTS
  Atrial septum puncture succeeded in all patients in the study group and in 72.6% of the patients in the control group (p < 0.01). The average fluoroscopy times for transseptal catheterization in the study and the control groups were 2.0 +/- 0.5 and 3.0 +/- 1.0 min, respectively (p < 0.01). Transseptal catheterization was subsequently achieved using the RA approach in the 14 patients from the control group in whom the LA approach failed.
  
  
  CONCLUSIONS
  The RA approach is a safe and effective means for transseptal catheterization in patients undergoing PBMV.
authors.affiliation: Department of Cardiology, Liaocheng People's Hospital, Taishan Medical College, Liaocheng, PRC.
authors.forename: Xiang-Quan
authors.initials: XQ
authors.lastname: Kong
authors.forename: Lexin
authors.initials: L
authors.lastname: Wang
authors.forename: Yu-Zeng
authors.initials: YZ
authors.lastname: Xue
authors.forename: Yue
authors.initials: Y
authors.lastname: Jin
authors.forename: Jing-Bo
authors.initials: JB
authors.lastname: Kong
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Wang
mesh_terms: D006328:Cardiac Catheterization; D002404:Catheterization; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D006346:Heart Septum / Q000473:pathology / Q000601:surgery*; D006349:Heart Valve Diseases / Q000150:complications / Q000628:therapy; D006801:Humans; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D012214:Rheumatic Heart Disease / Q000150:complications / Q000628:therapy; D012449:Safety; D012720:Severity of Illness Index; D016896:Treatment Outcome