Emerging applications for transseptal left heart catheterization old techniques for new procedures.
Transseptal (TS) catheterization was introduced in 1959 as a strategy to directly measure left atrial (LA) pressure. Despite acceptable feasibility and safety, TS catheterization has been replaced by indirect measurements of LA pressure using the Swan-Ganz catheter. Today, TS puncture is rarely performed for diagnostic purposes but continues to be performed for procedures such as balloon mitral valvuloplasty, antegrade balloon aortic valvuloplasty, and ablation of arrhythmias in the LA. Thus, the "art" of TS puncture has been lost, except in centers that perform these procedures with regularity. Recently, there has been a renewed interest in the TS technique because of emerging therapeutic procedures for structural heart disease and atrial fibrillation ablation. Invasive cardiologists will have to refamiliarize themselves with the TS technique, newer TS devices, and advanced ultrasound imaging for guidance of the procedure.
Andreas Gruentzig Cardiovascular Center, Emory University Hospital, Atlanta, Georgia 30322, USA. Vasilis.babaliaros@emoryhealthcare.org
Vasilis C
VC
Babaliaros
Jacob T
JT
Green
Stamatios
S
Lerakis
Michael
M
Lloyd
Peter C
PC
Block
D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D004594:Electrophysiology; D054092:Foramen Ovale, Patent / Q000628:therapy; D006325:Heart Atria / Q000000981:diagnostic imaging; D006344:Heart Septal Defects, Atrial / Q000628:therapy; D006346:Heart Septum; D006353:Heart-Assist Devices; D006801:Humans; D008943:Mitral Valve / Q000601:surgery; D011312:Pressure; D011677:Punctures / Q000295:instrumentation / Q000379:methods; D014463:Ultrasonography