THE TECHNIQUE AND SAFETY OF TRANSSEPTAL LEFT-HEART CATHETERIZATION - THE MASSACHUSETTS-GENERAL-HOSPITAL EXPERIENCE WITH 1,279 PROCEDURES

With the introduction of interventional procedures such as percutaneou s mitral valvuloplasty and radiofrequency ablation of left-sided bypas s tracts, there has been renewed interest in the technique of transsep tal left heart catheterization. We review our experience with 1,279 tr ansseptal catheterizations performed over the last 10 years. The most common indications for transseptal catheterization included direct mea surement of left atrial pressure or access to the left ventricle in pa tients with prosthetic aortic or mitral valves, and in patients underg oing percutaneous mitral valvuloplasty. A total of 17 major complicati ons occurred (1.3%), including cardiac tamponade (15 patients, 1.2%), systemic emboli (1 patient, 0.08%), and death secondary to aortic perf oration (0.08%). We conclude that when performed by experienced operat ors, transseptal left heart catheterization is associated with low mor bidity and mortality. (C) 1994 Wiley-Liss, Inc.