“…In patients with peripheral vascular disease, a brachial or radial approach is often used. However, other techniques are required in cases of arterial occlusive disease affecting all four extremities, and Pearce et al reported the first case of selective coronary angiography performed through a transseptal approach in 1992 [2]. Current indications for transseptal left heart catheterisation, originally reported by Brockenbrough et al in 1962 [3], include the evaluation of aortic and mitral valve function, diagnosis of congenital abnormalities, and antegrade mitral and aortic valvuloplasty.…”