Transseptal puncture and percutaneous mitral valvuloplasty

Transseptal puncture

Introduction

With the growing evolution and complexity of left-sided percutaneous electrophysiological and structural interventions verified during the last decades, there was an increasing need to perform transseptal catheterization. This technique was introduced in the late 50s by Ross et al 11. Ross J Jr, Braunwald E, Morrow AG. Transseptal left atrial puncture; new technique for the measurement of left atrial pressure in man. Am J Cardiol. 1959;3;653-5. Link, and later refined by Brockenbrough 22. Brockenbrough EC, Braunwald E, Ross Jr J. Transseptal left heart catheterization: A review of 450 studies and description of an improved technique. Circulation. 1962;25;15-21. Link and Mullins 33. Mullins CE. Transseptal left heart catheterization: experience with a new technique in 520 pediatric and adult patients. Pediatr Cardiol. 1983;4;239-245. Link. Its use suffered a major shift, from a diagnostic procedure to be nowadays mostly the access for left-sided percutaneous interventions. In the field of cardiac intervention, it is an obligatory step to perform the old percutaneous mitral balloon valvuloplasty (PBMV) and other more recent mitral interventions (such as MitraClip, annuloplasty or valve implantation), left atrial appendage (LAA) closure and percutaneous closure of paravalvular leaks.

The transseptal puncture...