ABSTRACT
Transseptal puncture, the gateway to the LA for a growing variety of structural heart disease and electophysiologic procedures, is of increasing importance in invasive cardiology. The significant benefits of proficiency in performing transseptals is somewhat offset by the substantial learning curve and complication profile associated with the procedure. However, the dramatic rise in number of transseptals performed has been accompanied by an expanding evidence base in the literature addressing issues such as optimal periprocedure management, in particular anticoagulation. A number of technologies, including adjunctive imaging and, more recently, equipment to facilitate the transseptal puncture itself, may improve the overall success rate and safety of this now half-century-old procedure.
Figure 23.19 Continued
