Special Technology Sessions-6159-Transseptal Catheterization

Video Transcription

Video Summary

In this video, Professor Dave Callens discusses transeptal catheterization techniques. Initially used to measure left atrial pressure, transeptal catheterization is now used for a variety of procedures including atrial fibrillation ablation, left atrial tachycardia, and ventricular tachycardia. Callens explains that although there were initial complications with the procedure, such as cardiac tamponade and stroke, the current instance of complications is low, especially in experienced centers.<br /><br />He goes on to discuss the importance of understanding the anatomy of the atrial septum and the surrounding structures to avoid complications. Callens explains the steps of the transeptal procedure, including the positioning of the transeptal apparatus, the puncture of the septum, and the advancement of the sheath to the left atrium. He also discusses the use of techniques such as pressure monitoring and echocardiographic guidance to aid in the procedure.<br /><br />Callens highlights the challenges of performing transeptal procedures in cases of a thick or fibrous septum, atrial septal aneurysms, and prior septal closure devices. He offers tips and tricks for navigating these difficult situations, such as using radiofrequency needles, inserting a stiff wire through the dilator, and performing atrial septoplasty.<br /><br />In conclusion, Callens emphasizes the importance of proper training and understanding of anatomy for performing transeptal catheterization safely and effectively. He notes that intracardiac echo is a valuable tool for guidance during the procedure and that advanced techniques are available for challenging cases.

Keywords

transeptal catheterization

complications

anatomy

pressure monitoring

echocardiographic guidance

atrial septum

tips and tricks