Transseptal left heart catheterisation guided by intracardiac echocardiography

Abstract

Intracardiac echocardiography is feasible to guide transseptal puncture. The optimal puncture site can be assessed by simultaneous detection of the characteristic downward jump of the transseptal needle onto the fossa ovalis by intracardiac ultrasound and fluoroscopy.

Trans-Septal Catheterization in the Electrophysiology Laboratory

“…It is noteworthy that five of the seven centers that reported cardiac perforation or needle puncture in 2003 routinely used auxiliary tools to assist the TSP-C procedure. This suggested that, although undoubtedly valuable in particular cases (9,(17)(18)(19), routine use of pressure recordings, pigtail positioning, and ultrasound was not necessarily associated with a lower complication rate. Nevertheless, it is intuitive that particularly the use of ultrasound, by visualizing the correct positioning of the distal part of the assembly and the fossa ovalis "tenting," could really be of help, especially in the early phase of the learning curve and whenever a peculiar anatomy is expected or encountered.…”

Assisted circulation using the TandemHeart® during very high‐risk PCI of the unprotected left main coronary artery in patients declined for CABG

“…TH insertion requires transeptal puncture. Direct visualization of the interatrial septum by intracardiac ultrasound (AcuNav ICE, Siemens Medical Systems, Mountain View, CA) may have contributed to the safety and increased efficacy of this procedure [17,18]. The most important drawback of the technique may be the difficulty of cannula insertion.…”

Ablation of atrial fibrillation

“…It provides a detailed an accurate definition of intracardiac structures. By providing a clear and direct visualization of the interatrial septum and fossa ovalis, it greatly facilitates transseptal puncture and potentially decreases complications [31,32].…”