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

Interventions for valvular disease and heart failure

Transseptal puncture: procedural guidance, challenging situations and management of complications

EuroIntervention 2021;17:720-727. DOI: 10.4244/EIJ-D-20-00454

1. University Hospital, Zurich, Switzerland; 2. Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; 3. Università Cattolica del Sacro Cuore, Rome, Italy

A number of interventional procedures based on the transseptal puncture (TSP) have been developed in recent 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 fluoro-scopy and of transoesophageal echocardiography (TEE) has increased safety and precision. However, TSP still represents a tricky procedure, which may become even more difficult in cases of challenging interatrial septa, and life-threatening complications may occur. Consequently, an in-depth knowledge of procedural steps, equipment, echocardiographic views, fossa ovalis anatomy and how to manage the most frequent complications is critical to performing a successful TSP.

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