ABSTRACT
Trans-septal puncture has now become an essential component of treatment for multiple interventions, including trans-catheter mitral valve repair and replacement, left atrial appendage closure, closure of para-valvular mitral prosthetic leaks, and atrial septostomy. This chapter describes the technique, the equipment and the procedure to follow for safe and successful trans-septal puncture, detailing the optimal puncture sites favoured for specific trans-septal interventions.
