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Review
. 2022 Aug;33(8):1927-1931.
doi: 10.1111/jce.15428. Epub 2022 Mar 8.

Transseptal access: A review of contemporary tools

Rachel M Kaplan  1 , Jeremiah Wasserlauf  2 , Bradley P Knight  1
Affiliations
Review

Transseptal access: A review of contemporary tools

Rachel M Kaplan et al. J Cardiovasc Electrophysiol. 2022 Aug.

Abstract

Transseptal left atrial catheterization is routinely used for many common catheter-based interventions. Tools for transseptal catheterization have advanced over the recent years. Such tools include imaging advances with intracardiac echocardiology as well as an array of needles, wires, and dilators to achieve transseptal access with greater ease and safety. This study will discuss the contemporary tools for transseptal catheterization and guidance for difficult cases.

Keywords: intracardiac echocardiography; radiofrequency needle; radiofrequency wire; transseptal.

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Figures

Figure 1
Figure 1
Images of the fossa ovalis with transseptal needle tenting the septum (A) and of 3D image of transseptal access below an atrial septal defect closure device (B)
Figure 2
Figure 2
Mechanical transseptal tools (needle—A, needle on wire—B) and radiofrequency assisted transseptal tools (needle—C, needle on wire—D)
Figure 3
Figure 3
Transseptal puncture sites from various technologies in an in vitro porcine atrial model
Figure 4
Figure 4
AcQcross™ integrated needle/dilator system (https://www.acutusmedical.com/media/Acutus-Medical-Transseptal-Product-Portfolio-MM-67-Rev-G.pdf)
Figure 5
Figure 5
Shoehorn technique for crossing difficult septum. Second catheter advanced into left atrium for dilation (A); the second catheter has been withdrawn and the sheath advanced into the left atrium (B)
See this image and copyright information in PMC

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