Experiences with transseptal left heart catheterization

Enghoff, Ebba; Cullhed, I

doi:10.1016/0002-8703(71)90111-6

Cited by 13 publications

(7 citation statements)

References 50 publications

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“…In our laboratory transeptal puncture is never attempted unless the operator is certain that the catheter has properly engaged the fossa ovalis. Failure to advance the transeptal catheter from the left atrium into the left ventricle occurred in 7.7% of our series, which compares favorably with other reports [13,14]. The overall failure rate to enter the left ventricle with the transeptal technique in patients with aortic stenosis in this series was 15 % .…”

Section: Discussionsupporting

confidence: 79%

“…Although this is slightly higher than the failure rate of up to 8% reported by other authors [5,[13][14][15],181, we have undertaken transeptal catheterization in patients who were often in advanced stages of disease with atrial enlargement. More than half of our failures (1 1 of 20) were due to inability to identify the fossa ovalis, which is likely to occur as the left atrium enlarges [9].…”

Section: Discussionmentioning

confidence: 65%

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Recent experience with transeptal catheterization

Lew

Harper

Federman

et al. 1983

Cathet. Cardiovasc. Diagn.

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We report our recent experience of 207 consecutive transeptal catheterizations performed in the following groups of patients: aortic valve disease in 152, mitral valve disease in 20, combined aortic and mitral valve disease in 11, hypertrophic obstructive cardiomyopathy in 11, assessment of prosthetic cardiac valves in nine, and four miscellaneous. Transeptal catheterization failed in 20 patients. There was no attempt to advance the transeptal catheter from the left atrium into the left ventricle in 18 patients, and failure to advance the transeptal catheter from the left atrium into the left ventricle occurred in 13 patients. Transeptal catheterization was achieved in a mean time of 9.7 +/- 4.6 SD min. There were no deaths, two major and four minor complications. We conclude that transeptal catheterization remains a useful technique that in experienced hands is both rapid and safe.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 65%

Recent experience with transeptal catheterization

Lew

Harper

Federman

et al. 1983

Cathet. Cardiovasc. Diagn.

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“…Failure to enter the left atrium occurred in 8.6% of our series, which is comparable with the failure rate of up to 10% reported by other authors (Brockenbrough et al, 1962;Enghoff and Cullhed, 1971;Lew et al, 1983). Failure to advance the transseptal catheter from the left atrium into the left ventricle occurred in 3.9 % of our series, which compares favorably with other reports (Brockenbrough et al, 1962;Enghoff and Cullhed, 1971; Lew et al, 1983).…”

Section: Discussionsupporting

confidence: 91%

“…With the exception of the retrograde aortic catheterization technique, these methods all had diagnostic limitations, were associated with technical difficulties, and were potentially dangerous as well as painful (Bagger et Failure to enter the left atrium occurred in 8.6% of our series, which is comparable with the failure rate of up to 10% reported by other authors (Brockenbrough et al, 1962;Enghoff and Cullhed, 1971;Lew et al, 1983). Failure to advance the transseptal catheter from the left atrium into the left ventricle occurred in 3.9 % of our series, which compares favorably with other reports (Brockenbrough et al, 1962;Enghoff and Cullhed, 1971;Lew et al, 1983).…”

Section: Discussionsupporting

confidence: 79%

Transseptal left heart catheterization: A review of 278 studies

B‐Lundqvist

Olsson

Varnauskas

1986

Clinical Cardiology

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Summary:In our laboratory, we performed 278 transseptal left heart catheterizations in adult patients over a period of 13 years. The left atrium was entered in 91.4% of the intended left heart catheterizations. Of 252 attempts, the left ventricle was entered in 96.1 % . Major complications were aortic puncture (0.7%), pericardial puncture/suspected tamponade (3.2 %), systemic arterial embolism (1.1 %), and suspected perforation of the inferior vena cava (0.4%). There were no deaths. Although less frequently performed during the last decade, the transseptal catheterization technique has a complication rate of the same magnitude as during periods when this method was more commonly applied.

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“…In some cases, a stronger than usual push achieved successful crossing but the operator has to be alert to restricting the forward motion as soon as the catheter is within the left atrium. Extremes of force have to be avoided as the needle tip can fracture from its shaft.9 10 If the needle did not cross the septum a different position, usually a lower one within the left atrial visual target area, was tried. If the needle crossed a tough septum but the catheter would not follow then a change from an adult to a paediatric Brockenbrough catheter and needle could be successful.…”

Section: Crossing Of Atrial Septummentioning

confidence: 99%

Anterior staircase manoeuvre for atrial transseptal puncture.

Shaw

1994

Heart

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After a Brockenbrough or Mullins transseptal catheter had been advanced into the lower half of the right atrium through a J shaped guidewire, the guidewire was removed and the curved tip Brockenbrough needle was advanced so that its tip lay just within the catheter. The needle was rotated so that the direction arrow at its hub faced 12 o'clock as viewed from below (fig 1). With the needle and catheter constantly moved from side to side between the 10 and 2 o'clock positions, the catheter and needle were advanced to the top of the right atrium and then rotated posteromedially (fig 1). The continual side to side movement as the catheter and needle advanced to the top of the right atrium immediately detected any tendency to snag on the atrial wall. Snagging rarely occurred because when the inferior vena cava enters at the posterior aspect of right atrium there is an anterior space in which this anterior staircase movement can take place (fig 2)

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Experiences with transseptal left heart catheterization

Cited by 13 publications

References 50 publications

Recent experience with transeptal catheterization

Recent experience with transeptal catheterization

Transseptal left heart catheterization: A review of 278 studies

Anterior staircase manoeuvre for atrial transseptal puncture.

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