Transseptal Catheterization and Interventions PDF
7.44 MB PDF
Transseptal catheterization was introduced half a century ago by Drs. John Ross Jr., Constantin Cope, and Eugene Braunwald as a technique for measuring left atrial pressure. Valvular heart disease was common at that time, even in the Western world, and our understanding of cardiovascular physiology was in a nascent stage. Due to the potential for complications, particularly in inexperienced hands, the technique became cloaked in danger and intrigue in the 1960s. In the 1970s, echocardiography and Doppler assessment of valvular lesions and pressure measurements became available; transseptal catheterization became somewhat redundant and the procedure fell out of favor. Modern interventional cardiologists became interested in this technique with the advent of percutaneous mitral valvuloplasty, which was introduced in the mid-1980s. Shortly thereafter, cardiac electrophysiologists became interested in the technique for ablation of leftsided accessory pathways and left atrial tachycardias. The development of catheter ablation for atrial fibrillation and new therapeutic interventions for the interventional cardiologist began a resurgence of the technique.
It is surprising that this important technique has not been the subject of a textbook until now. Readers and those learning the technique for the first time have had to search the literature for the pertinent information on their own. This textbook provides important discussion about topics relevant for all readers interested in safely performing transseptal catheterization, from embryology and anatomy of the interatrial septum to detailed discussions about the various methods, and illustrations of difficult cases, complications, and new technologies for improving safety and efficacy. Some readers will find specific chapters of particular interest to them: transseptal technique in pediatric cardiology (chapter 9), emerging applications in interventional cardiology (chapters 11 and 12) and left atrial appendage closure (chapter 13) will be of interest to interventionalists as well as electrophysiologists.
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