TRANSESOPHAGEAL ECHOCARDIOGRAPHICALLY GUIDED ATRIAL TRANSSEPTAL CATHETERIZATION IN PATIENTS WITH NORMAL-SIZED ATRIA - INCIDENCE OF COMPLICATIONS

The incidence of cardiac complications from atrial transseptal cathete rization has never been quantified in patients with normal-sized atria . Series defining the complication rate are derived from diseased hear ts with structural changes that may alter the complication rate of the procedure. The generation of a standardized incidence of perforation in a population of structurally normal atria has important implication s. A total of 46 atrial transseptal catheterizations guided by transes ophageal echocardiography (TEE) for radiofrequency ablation of left-si ded accessory pathways was performed in 42 patients during a 3-year pe riod (1990-1993). Clinical and echocardiographic data were analyzed, w ith special attention given to TEE reports pre- and post-transseptal c atheterization. Only one complication occurred in the 46 procedures (2 .2%): a perforation of the left atrium that led to pericardial effusio n and cardiac tamponade. In a small series of patients with normal-siz ed atria, we have demonstrated that TEE-guided transseptal catheteriza tion is a procedure with a low complication rate.