Transseptal Catheterization: Considerations and Caveats

Transseptal catheterization is used by interventional cardiologists to gain access in the left atrium. This technique was initially introduced for left-sided pressure measurements and has been integrated in a variety of procedures including left atrial ablations and percutaneous mitral valvuloplasties. The establishment of catheter ablation of atrial fibrillation as an effective treatment strategy has brought transseptal catheterization back to the limelight. Technique refinements, introduction of adjunctive imaging tools, and enrichment of available technical equipment have simplified the procedure. In the present article we review the technique of transseptal catheterization, presenting tips and caveats that could be of value for safe and successful transseptal punctures.