The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Transseptal Puncture: Procedural Guidance, Challenging Situations and Complications Management.

DOI: 10.4244/EIJ-D-20-00454

1. UniversitatsSpital Zurich, University Heart Center, Zurich, Switzerland
2. University Hospital, Zurich, Switzerland
3. University Hospital Zurich, Switzerland, Switzerland

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A number of interventional procedures based on the transseptal puncture (TSP) have been developed over the last years. The increasing number of interventional procedures, as well as the use of large-bore sheaths and complex devices, has led to improvements in technique and equipment. The combined use of fluoroscopy and of trans-esophageal echocardiography (TEE) has increased safety and precision. However, TSP still represents a tricky procedure, it may become even more difficult in case of challenging interatrial septa and life-threatening complications may occur. Consequently, a deep knowledge of procedural steps, equipment, echocardiographic views, fossa ovalis anatomy and most frequent complications management are critical to perform successful TSP.

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