title: Transseptal puncture by CTP-2 method: Results from cardiac computed tomography analysis and clinical application.
abstract: The current used parameters for transseptal puncture (TSP) under fluoroscopic guidance is from left atriography and need to be verified by precise anatomic measurement. From February 2009 to July 2013, consecutive patients who received computed tomography (CT) were included. Landmarks and parameters were preliminary studied by right atriography, and further evaluated on the CT images of 1001 patients. A method (CTP-2) was proposed for guiding TSP. In right anterior oblique 45° view, the CTP-2 method was defined by points C, T, and P, and 2 areas: point C is in coronary sinus; point T is at a distance of dCT (usually 1.5 ± 0.2 vertebral height) over point C; then point P, the optimal puncture site, was located at 0.5 ± 0.2 vertebral body height posterior to point T; puncture should avoid the aortic root area and the rear triangle area; the aortic root area could be negatively revealed by right atriography at the orifice of inferior vena cava, and the rear triangle area is demarcated by points C, C', and T' (C' and T' are 2 points horizontally posterior to, and at dCT away from points C and T, respectively). The initial application of CTP-2 in 2820 patients showed that it might be helpful in reducing the need of left atriography and the possibility of cardiac perforation.
authors: Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China St David's Medical Center, Austin, TX Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University Heart Center, Center for Atrial Fibrillation, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Karamay Central Hospital, Karamay, Xinjiang, China.
authors: Yan
authors: Y
authors: Wang
authors: Guangzhi
authors: G
authors: Chen
authors: Yang
authors: Y
authors: Bai
authors: Sheng
authors: S
authors: Li
authors: Andrea
authors: A
authors: Natale
authors: Jianzeng
authors: J
authors: Dong
authors: Hong
authors: H
authors: Wang
authors: Caihua
authors: C
authors: Sang
authors: Ronghui
authors: R
authors: Yu
authors: Deyong
authors: D
authors: Long
authors: Ribo
authors: R
authors: Tang
authors: Xingpeng
authors: X
authors: Liu
authors: Xiaopeng
authors: X
authors: Zhao
authors: Yuanwen
authors: Y
authors: Jiang
authors: Changsheng
authors: C
authors: Ma
authors: Dao Wen
authors: DW
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D059925:Anatomic Landmarks; D000790:Angiocardiography; D001011:Aorta / Q000000981:diagnostic imaging; D006348:Cardiac Surgical Procedures / Q000379:methods*; D054326:Coronary Sinus / Q000000981:diagnostic imaging; D005260:Female; D005471:Fluoroscopy; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006346:Heart Septum / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging