ABSTRACT
Transseptal catheterization, which allows access to the le atrium, is the rst step of the percutaneous mitral valvuloplasty procedure and one of the most crucial. Transseptal le heart catheterization was introduced independently in 1959 by Ross and Cope, and later modied by Brockenbrough and Mullins.1-4 e procedure was introduced as an alternative to the methods available at that time, such as directly measuring le atrial and le ventricular pressures using either the transbronchial or transthoracic approaches.5 e developments of the otation pulmonary artery catheter in 1970 by Swan and Ganz6 and retrograde cardiac catheterization of the le ventricle led to a signicant decline in the utilization of the transseptal technique. Furthermore, with fewer patients with valvular disease and improved echocardiography, a smaller number of cardiologists were trained to perform the procedure.7,8 With fewer procedures came fewer qualied personnel, and, because of concern over potentially grave complications and associated mortality, the procedure attained an “aura of danger and intrigue.”9 With the introduction of interventional procedures such as percutaneous mitral valvuloplasty, antegrade percutaneous aortic valvuloplasty, and now radio-frequency ablation of le-sided bypass tracts, there has been an increased demand for, and rekindled interest in, transseptal catheterization.10,11 We will describe the technique, indications, and complications of transseptal le heart catheterization in this chapter.
