Access to the left atrium is required for several minimally invasive cardiac interventions in the left heart. For this purpose, transseptal puncture (TSP) technique is often performed, perforating the atrial septum under fluoroscopic or/and ultrasound imaging guidance. Although this approach has been used for many years, complications/failures are not uncommon mainly in patients with abnormal atrial anatomy and repeated TSP. Thus, this study presents an overview of methods and techniques that have been proposed to increase the safety and feasibility of the TSP. A systematic review of literature was conducted through the analysis of the articles published between 2008 and 2015. The search was performed in PubMed, Scopus, and ISI Web of Knowledge using the expression “transseptal puncture.” A total of 354 articles were retrieved from the databases, and 64 articles were selected for this review. Moreover, these 64 articles were divided into four categories, namely: (1) incidence studies, (2) intraprocedural guidance techniques, (3) preprocedural planning methods, and (4) surgical instruments. A total of 36 articles focused on incidence studies, 24 articles suggested novel intraprocedural guidance techniques, 5 works focused on preprocedural planning strategies, and 21 works proposed surgical instruments. The novel 3D guidance techniques, radio-frequency surgical instruments, and pre-interventional planning approaches showed potential to overcome the main procedural limitations/complications, through the reduction of the intervention time, radiation, number of failures, and complications.

References

References
1.
Babaliaros
,
V. C.
,
Green
,
J. T.
,
Lerakis
,
S.
,
Lloyd
,
M.
, and
Block
,
P. C.
,
2008
, “
Emerging Applications for Transseptal Left Heart Catheterization Old Techniques for New Procedures
,”
J. Am. Coll. Cardiol.
,
51
(
22
), pp.
2116
2122
.
2.
Matsumoto
,
T.
, and
Kar
,
S.
,
2013
, “
Latest Advances in Transseptal Structural Heart Interventions
,”
Circul. J.
,
78
(
8
), pp.
1782
1790
.
3.
Earley
,
M. J.
,
2009
, “
How to Perform a Transseptal Puncture
,”
Heart
,
95
(
1
), pp.
85
92
.
4.
Schwagten
,
B.
,
Jordaens
,
L.
,
Rivero-Ayerza
,
M.
,
Van Belle
,
Y.
,
Knops
,
P.
,
Thornton
,
I.
, and
Szili-Torok
,
T.
,
2010
, “
A Randomized Comparison of Transseptal and Transaortic Approaches for Magnetically Guided Ablation of Left-Sided Accessory Pathways
,”
Pacing Clin. Electrophysiol.
,
33
(
11
), pp.
1298
1303
.
5.
Ross
,
J.
,
2008
, “
Transseptal Left Heart Catheterization: A 50-Year Odyssey
,”
J. Am. Coll. Cardiol.
,
51
(
22
), pp.
2107
2115
.
6.
Yao
,
Y.
,
Ding
,
L.
,
Chen
,
W.
,
Guo
,
J.
,
Bao
,
J.
,
Shi
,
R.
,
Huang
,
W.
,
Zhang
,
S.
, and
Wong
,
T.
,
2013
, “
The Training and Learning Process of Transseptal Puncture Using a Modified Technique
,”
Europace
,
15
(12), p.
eut078
.
7.
Hsu
,
J. C.
,
Badhwar
,
N.
,
Gerstenfeld
,
E. P.
,
Lee
,
R. J.
,
Mandyam
,
M. C.
,
Dewland
,
T. A.
,
Imburgia
,
K. E.
,
Hoffmayer
,
K. S.
,
Vedantham
,
V.
, and
Lee
,
B. K.
,
2013
, “
Randomized Trial of Conventional Transseptal Needle Versus Radiofrequency Energy Needle Puncture for Left Atrial Access (the TRAVERSE-LA Study)
,”
J. Am. Heart Assoc.
,
2
(
5
), p.
e000428
.
8.
Fromentin
,
S.
,
Sarrazin
,
J.-F.
,
Champagne
,
J.
,
Nault
,
I.
,
Philippon
,
F.
,
Molin
,
F.
,
Blier
,
L.
, and
O'Hara
,
G.
,
2011
, “
Prospective Comparison Between Conventional Transseptal Puncture and Transseptal Needle Puncture With Radiofrequency Energy
,”
J. Interventional Card. Electrophysiol.
,
31
(
3
), pp.
237
242
.
9.
Mitchell-Heggs
,
L.
,
Lellouche
,
N.
,
Deal
,
L.
,
Elbaz
,
N.
,
Hamdaoui
,
B.
,
Castanié
,
J.-B.
,
Dubois-Randé
,
J.-L.
,
Guéret
,
P.
, and
Lim
,
P.
,
2010
, “
Transseptal Puncture Using Minimally Invasive Echocardiography During Atrial Fibrillation Ablation
,”
Europace
,
12
(
10
), pp.
1435
1438
.
10.
Lakkireddy
,
D.
,
Rangisetty
,
U.
,
Prasad
,
S.
,
Verma
,
A.
,
Biria
,
M.
,
Berenbom
,
L.
,
Pimentel
,
R.
,
Emert
,
M.
,
Rosamond
,
T.
, and
Fahmy
,
T.
,
2008
, “
Intracardiac Echo-Guided Radiofrequency Catheter Ablation of Atrial Fibrillation in Patients With Atrial Septal Defect or Patent Foramen Ovale Repair: A Feasibility, Safety, and Efficacy Study
,”
J. Cardiovasc. Electrophysiol.
,
19
(
11
), pp.
1137
1142
.
11.
Lim
,
H. E.
,
Pak
,
H.-N.
,
Tse
,
H.-F.
,
Lau
,
C.-P.
,
Hwang
,
C.
, and
Kim
,
Y.-H.
,
2009
, “
Catheter Ablation of Atrial Fibrillation Via Superior Approach in Patients With Interruption of the Inferior Vena Cava
,”
Heart Rhythm
,
6
(
2
), pp.
174
179
.
12.
Ho
,
S. Y.
,
McCarthy
,
K. P.
, and
Faletra
,
F. F.
,
2011
, “
Anatomy of the Left Atrium for Interventional Echocardiography
,”
Eur. Heart J.-Cardiovasc. Imaging
,
12
(
10
), pp.
i11
i15
.
13.
Knecht
,
S.
,
Wright
,
M.
,
Lellouche
,
N.
,
Nault
,
I.
,
Matsuo
,
S.
,
O'Neill
,
M. D.
,
Lomas
,
O.
,
Deplagne
,
A.
,
Bordachar
,
P.
, and
Sacher
,
F.
,
2008
, “
Impact of a Patent Foramen Ovale on Paroxysmal Atrial Fibrillation Ablation
,”
J. Cardiovasc. Electrophysiol.
,
19
(
12
), pp.
1236
1241
.
14.
Moher
,
D.
,
Liberati
,
A.
,
Tetzlaff
,
J.
,
Altman
,
D. G.
, and
Group
,
P.
,
2010
, “
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
,”
Int. J. Surg.
,
8
(
5
), pp.
336
341
.
15.
von Alvensleben
,
J. C.
,
Dick
,
M.
, II
,
Bradley
,
D. J.
, and
LaPage
,
M. J.
,
2014
, “
Transseptal Access in Pediatric and Congenital Electrophysiology Procedures: Defining Risk
,”
J. Interventional Card. Electrophysiol.
,
41
(
3
), pp.
273
277
.
16.
Elayi
,
C. S.
,
Gurley
,
J. C.
,
Di Sessa
,
T. G.
, and
Kakavand
,
B.
,
2011
, “
Surgical Electrocautery Facilitated Transseptal Puncture in Children
,”
Pacing Clin. Electrophysiol.
,
34
(
7
), pp.
827
831
.
17.
Clark
,
J.
,
Bockoven
,
J.
,
Lane
,
J.
,
Patel
,
C.
, and
Smith
,
G.
,
2008
, “
Use of Three-Dimensional Catheter Guidance and Trans-Esophageal Echocardiography to Eliminate Fluoroscopy in Catheter Ablation of Left-Sided Accessory Pathways
,”
Pacing Clin. Electrophysiol.
,
31
(
3
), pp.
283
289
.
18.
Jauvert
,
G.
,
Grimard
,
C.
,
Lazarus
,
A.
, and
Alonso
,
C.
,
2014
, “
Comparison of a Radiofrequency Powered Flexible Needle With a Classic Rigid Brockenbrough Needle for Transseptal Punctures in Terms of Safety and Efficacy
,”
Heart, Lung Circ.
,
24
(2), pp. 173–179.
19.
Bayrak
,
F.
,
Chierchia
,
G.-B.
,
Namdar
,
M.
,
Yazaki
,
Y.
,
Sarkozy
,
A.
,
de Asmundis
,
C.
,
Muller-Burri
,
S. A.
,
Rao
,
J.
,
Ricciardi
,
D.
, and
Sorgente
,
A.
,
2012
, “
Added Value of Transesophageal Echocardiography During Transseptal Puncture Performed by Inexperienced Operators
,”
Europace
,
14
(
5
), pp.
661
665
.
20.
Yao
,
Y.
,
Guo
,
J.
,
Ding
,
L.
,
Bao
,
J.
,
Huang
,
W.
,
Shi
,
R.
,
Wu
,
L.
, and
Zhang
,
S.
,
2012
, “
Improved Approach to Atrial Septum Puncture: Experience in 539 Cases
,”
Chin. Med. J.
,
125
(
6
), pp.
1179
1181
.
21.
Wadehra
,
V.
,
Buxton
,
A. E.
,
Antoniadis
,
A. P.
,
McCready
,
J. W.
,
Redpath
,
C. J.
,
Segal
,
O. R.
,
Rowland
,
E.
,
Lowe
,
M. D.
,
Lambiase
,
P. D.
, and
Chow
,
A. W.
,
2011
, “
The Use of a Novel Nitinol Guidewire to Facilitate Transseptal Puncture and Left Atrial Catheterization for Catheter Ablation Procedures
,”
Europace
,
13
(10), p.
eur155
.
22.
Wieczorek
,
M.
,
Hoeltgen
,
R.
,
Akin
,
E.
, and
Salili
,
A. R.
,
2010
, “
Use of a Novel Needle Wire in Patients Undergoing Transseptal Puncture Associated With Severe Septal Tenting
,”
J. Interventional Card. Electrophysiol.
,
27
(
1
), pp.
9
13
.
23.
Mulder
,
A. A.
,
Balt
,
J. C.
,
Wijffels
,
M. C.
,
Wever
,
E. F.
, and
Boersma
,
L. V.
,
2012
, “
Safety of Pulmonary Vein Isolation and Left Atrial Complex Fractionated Atrial Electrograms Ablation for Atrial Fibrillation With Phased Radiofrequency Energy and Multi-Electrode Catheters
,”
Europace
,
14
(
10
), pp.
1433
1440
.
24.
Tang
,
R.-B.
,
Dong
,
J.-Z.
,
Long
,
D.-Y.
,
Yu
,
R.-H.
,
Liu
,
X.-P.
,
Cheng
,
Y.-L.
,
Sang
,
C.-H.
,
Ning
,
M.
,
Jiang
,
C.-X.
, and
Avula
,
U. M. R.
,
2014
, “
Incidence and Clinical Characteristics of Transient ST-T Elevation During Transseptal Catheterization for Atrial Fibrillation Ablation
,”
Europace
,
17
(4), p.
euu278
.
25.
Zellerhoff
,
S.
,
Daly
,
M.
,
Lim
,
H. S.
,
Denis
,
A.
,
Komatsu
,
Y.
,
Jesel
,
L.
,
Derval
,
N.
,
Sacher
,
F.
,
Cochet
,
H.
, and
Knecht
,
S.
,
2014
, “
Pulmonary Vein Isolation Using a Circular, Open Irrigated Mapping and Ablation Catheter (nMARQ): A Report on Feasibility and Efficacy
,”
Europace
,
16
(9), p.
euu133
.
26.
Miyazaki
,
S.
,
Shah
,
A. J.
,
Nault
,
I.
,
Wright
,
M.
,
Jadidi
,
A. S.
,
Forclaz
,
A.
,
Liu
,
X.
,
Linton
,
N.
,
Xhaet
,
O.
, and
Rivard
,
L.
,
2011
, “
Impact of Patent Foramen Ovale on Left Atrial Linear Lesions in the Context of Atrial Fibrillation Ablation
,”
J. Cardiovasc. Electrophysiol.
,
22
(
8
), pp.
846
850
.
27.
Knecht
,
S.
,
Jaïs
,
P.
,
Nault
,
I.
,
Wright
,
M.
,
Matsuo
,
S.
,
Madaffari
,
A.
,
Lellouche
,
N.
,
O'Neill
,
M. D.
,
Derval
,
N.
, and
Deplagne
,
A.
,
2008
, “
Radiofrequency Puncture of the Fossa Ovalis for Resistant Transseptal Access
,”
Circ.: Arrhythmia Electrophysiol.
,
1
(
3
), pp.
169
174
.
28.
Smelley
,
M. P.
,
Shah
,
D. P.
,
Weisberg
,
I.
,
Kim
,
S. S.
,
Lin
,
A. C.
,
Beshai
,
J. F.
,
Burke
,
M. C.
, and
Knight
,
B. P.
,
2010
, “
Initial Experience Using a Radiofrequency Powered Transseptal Needle
,”
J. Cardiovasc. Electrophysiol.
,
21
(
4
), pp.
423
427
.
29.
Lehrmann
,
H.
,
Schneider
,
J.
,
Jadidi
,
A. S.
,
Park
,
C. I.
,
Schiebeling-Römer
,
J.
,
Allgeier
,
J.
,
Arentz
,
T.
, and
Weber
,
R.
,
2014
, “
Transseptal Access for Left Atrial Ablation: The Catheter-Probing Techniques are Not Without Risk
,”
J. Cardiovasc. Electrophysiol.
,
25
(
5
), pp.
479
484
.
30.
Esch
,
J. J.
,
Triedman
,
J. K.
,
Cecchin
,
F.
,
Alexander
,
M. E.
, and
Walsh
,
E. P.
,
2013
, “
Radiofrequency-Assisted Transseptal Perforation for Electrophysiology Procedures in Children and Adults With Repaired Congenital Heart Disease
,”
Pacing Clin. Electrophysiol.
,
36
(
5
), pp.
607
611
.
31.
Hu
,
Y.-F.
,
Tai
,
C.-T.
,
Lin
,
Y.-J.
,
Chang
,
S.-L.
,
Lo
,
L.-W.
,
Wongcharoen
,
W.
,
Udyavar
,
A. R.
,
Tuan
,
T.-C.
, and
Chen
,
S.-A.
,
2008
, “
The Change in the Fluoroscopy-Guided Transseptal Puncture Site and Difficult Punctures in Catheter Ablation of Recurrent Atrial Fibrillation
,”
Europace
,
10
(
3
), pp.
276
279
.
32.
Tomlinson
,
D. R.
,
Sabharwal
,
N.
,
Bashir
,
Y.
, and
Betts
,
T. R.
,
2008
, “
Interatrial Septum Thickness and Difficulty With Transseptal Puncture During Redo Catheter Ablation of Atrial Fibrillation
,”
Pacing Clin. Electrophysiol.
,
31
(
12
), pp.
1606
1611
.
33.
Faletra
,
F. F.
,
Nucifora
,
G.
, and
Ho
,
S. Y.
,
2011
, “
Imaging the Atrial Septum Using Real-Time Three-Dimensional Transesophageal Echocardiography: Technical Tips, Normal Anatomy, and Its Role in Transseptal Puncture
,”
J. Am. Soc. Echocardiography
,
24
(
6
), pp.
593
599
.
34.
Gafoor
,
S.
,
Schulz
,
P.
,
Heuer
,
L.
,
Matic
,
P.
,
Franke
,
J.
,
Bertog
,
S.
,
Reinartz
,
M.
,
Vaskelyte
,
L.
,
Hofmann
,
I.
, and
Sievert
,
H.
,
2015
, “
Use of EchoNavigator, a Novel Echocardiography-Fluoroscopy Overlay System, for Transseptal Puncture and Left Atrial Appendage Occlusion
,”
J. Interventional Cardiol.
,
28
(
2
), pp.
215
217
.
35.
Chierchia
,
G. B.
,
Capulzini
,
L.
,
de Asmundis
,
C.
,
Sarkozy
,
A.
,
Roos
,
M.
,
Paparella
,
G.
,
Boussy
,
T.
,
Van Camp
,
G.
,
Kerkhove
,
D.
, and
Brugada
,
P.
,
2008
, “
First Experience With Real-Time Three-Dimensional Transesophageal Echocardiography-Guided Transseptal in Patients Undergoing Atrial Fibrillation Ablation
,”
Europace
,
10
(
11
), pp.
1325
1328
.
36.
Faletra
,
F. F.
,
Pedrazzini
,
G.
,
Pasotti
,
E.
,
Muzzarelli
,
S.
,
Dequarti
,
M. C.
,
Murzilli
,
R.
,
Schlossbauer
,
S. A.
,
Slater
,
I. P.
, and
Moccetti
,
T.
,
2014
, “
3D TEE During Catheter-Based Interventions
,”
JACC: Cardiovasc. Imaging
,
7
(
3
), pp.
292
308
.
37.
Stec
,
S.
,
Zaborska
,
B.
,
Sikora-Frąc
,
M.
,
Kryński
,
T.
, and
Kułakowski
,
P.
,
2011
, “
First Experience With Microprobe Transesophageal Echocardiography in Non-Sedated Adults Undergoing Atrial Fibrillation Ablation: Feasibility Study and Comparison With Intracardiac Echocardiography
,”
Europace
,
13
(
1
), pp.
51
56
.
38.
Wu
,
T.-G.
,
Wang
,
L.-X.
,
Chen
,
S.-W.
,
Lin
,
Z.-Q.
,
Yan
,
C.-J.
, and
Huang
,
L.-P.
,
2007
, “
Value of Radiographic Esophageal Imaging in Determining an Optimal Atrial Septal Puncture Site for Percutaneous Balloon Mitral Valvuloplasty
,”
Med. Princ. Pract.
,
17
(
4
), pp.
280
283
.
39.
Ferguson
,
J. D.
,
Helms
,
A.
,
Mangrum
,
J. M.
,
Mahapatra
,
S.
,
Mason
,
P.
,
Bilchick
,
K.
,
McDaniel
,
G.
,
Wiggins
,
D.
, and
DiMarco
,
J. P.
,
2009
, “
Catheter Ablation of Atrial Fibrillation Without Fluoroscopy Using Intracardiac Echocardiography and Electroanatomic Mapping
,”
Circ.: Arrhythmia Electrophysiol.
,
2
(
6
), pp.
611
619
.
40.
Liang
,
K.-W.
,
Fu
,
Y.-C.
,
Lee
,
W.-L.
,
Wang
,
K.-Y.
,
Ting
,
C.-T.
,
Jan
,
S.-L.
,
Lin
,
W.-W.
, and
Lin
,
I.-H.
,
2010
, “
Comparisons of Mechanical Versus Phase-Array Intracardiac Echocardiography-Assisted Transseptal Puncture in Patients With Dilated Left Atrium Undergoing Percutaneous Transvenous Mitral Commissurotomy
,”
J. Chin. Med. Assoc.
,
73
(
9
), pp.
471
476
.
41.
Ruisi
,
C. P.
,
Brysiewicz
,
N.
,
Asnes
,
J. D.
,
Sugeng
,
L.
,
Marieb
,
M.
,
Clancy
,
J.
, and
Akar
,
J. G.
,
2013
, “
Use of Intracardiac Echocardiography During Atrial Fibrillation Ablation
,”
Pacing Clin. Electrophysiol.
,
36
(
6
), pp.
781
788
.
42.
Russo
,
A. D.
,
Russo
,
E.
,
Fassini
,
G.
,
Casella
,
M.
,
Innocenti
,
E.
,
Zucchetti
,
M.
,
Cefalú
,
C.
,
Solimene
,
F.
,
Mottola
,
G.
, and
Colombo
,
D.
,
2013
, “
Role of Intracardiac Echocardiography in Atrial Fibrillation Ablation
,”
Journal of Atrial Fibrillation
,
5
(
6
), pp. 118–135.
43.
Biermann
,
J.
,
Bode
,
C.
, and
Asbach
,
S.
,
2012
, “
Intracardiac Echocardiography During Catheter-Based Ablation of Atrial Fibrillation
,”
Cardiol. Res. Pract.
,
2012
, p. 921746.
44.
Elagha
,
A. A.
,
Kocaturk
,
O.
,
Guttman
,
M. A.
,
Ozturk
,
C.
,
Kim
,
A. H.
,
Burton
,
G. W.
,
Kim
,
J. H.
,
Raman
,
V. K.
,
Raval
,
A. N.
, and
Wright
,
V. J.
,
2008
, “
Real-Time MR Imaging–Guided Laser Atrial Septal Puncture in Swine
,”
J. Vasc. Interventional Radiol.
,
19
(
9
), pp.
1347
1353
.
45.
Thiagalingam
,
A.
,
D'Avila
,
A.
,
Foley
,
L.
,
Fox
,
M.
,
Rothe
,
C.
,
Miller
,
D.
,
Malchano
,
Z.
,
Ruskin
,
J. N.
, and
Reddy
,
V. Y.
,
2008
, “
Full-Color Direct Visualization of the Atrial Septum to Guide Transseptal Puncture
,”
J. Cardiovasc. Electrophysiol.
,
19
(
12
), pp.
1310
1315
.
46.
Jeevan
,
M.
,
Jebaraj
,
R.
, and
Krishnakumar
,
R.
, “
In-Vitro Validation of Image Guided Surgery System With 3D Pre-Operative Visualization for Atrial Transseptal Puncture
,”
IEEE
18th International Conference on Information Visualisation (IV)
, July 16–18, pp.
342
345
.
47.
Shepherd
,
E. J.
,
Gall
,
S. A.
, and
Furniss
,
S. S.
,
2008
, “
Interatrial Septal Puncture Without the Use of Fluoroscopy—Reducing Ionizing Radiation in Left Atrial Ablation Procedures
,”
J. Interventional Card. Electrophysiol.
,
22
(
3
), pp.
183
187
.
48.
Nguyen
,
B.
,
Merino
,
J.
,
Shachar
,
Y.
,
Estrada
,
A.
,
Doiny
,
D.
,
Castrejon
,
S.
,
Marx
,
B.
,
Johnson
,
D.
,
Marfori
,
W.
, and
Gang
,
E. S.
,
2013
, “
Non-Fluoroscopic Transseptal Catheterization During Electrophysiology Procedures Using a Remote Magnetic Navigation System
,”
J. Atrial Fibrillation
,
6
(
4
), pp.
6
9
.
49.
Pavlović
,
N.
,
Reichlin
,
T.
,
Kühne
,
M.
,
Knecht
,
S.
,
Osswald
,
S.
, and
Sticherling
,
C.
,
2014
, “
Fluoroscopy-Free Recrossing of the Interatrial Septum During Left Atrial Ablation Procedures
,”
J Interventional Card. Electrophysiol.
,
41
(
3
), pp.
261
266
.
50.
Unnithan
,
A. G.
,
Dexter
,
B. C.
,
Law
,
I. H.
, and
Von Bergen
,
N. H.
,
2014
, “
Limiting Left-Sided Catheter Dwelling Time Using 3D NavX to Mark and Reaccess the Left Atrium Via Prior Transseptal Puncture Site
,”
J. Interventional Card. Electrophysiol.
,
40
(
2
), pp.
125
128
.
51.
Mah
,
D. Y.
,
Miyake
,
C. Y.
,
Sherwin
,
E. D.
,
Walsh
,
A.
,
Anderson
,
M. J.
,
Western
,
K.
,
Abrams
,
D. J.
,
Alexander
,
M. E.
,
Cecchin
,
F.
, and
Walsh
,
E. P.
,
2014
, “
The Use of an Integrated Electroanatomic Mapping System and Intracardiac Echocardiography to Reduce Radiation Exposure in Children and Young Adults Undergoing Ablation of Supraventricular Tachycardia
,”
Europace
,
16
(
2
), pp.
277
283
.
52.
Saliba
,
W.
,
Reddy
,
V. Y.
,
Wazni
,
O.
,
Cummings
,
J. E.
,
Burkhardt
,
J. D.
,
Haissaguerre
,
M.
,
Kautzner
,
J.
,
Peichl
,
P.
,
Neuzil
,
P.
, and
Schibgilla
,
V.
,
2008
, “
Atrial Fibrillation Ablation Using a Robotic Catheter Remote Control System: Initial Human Experience and Long-Term Follow-Up Results
,”
J. Am. Coll. Cardiol.
,
51
(
25
), pp.
2407
2411
.
53.
Wagdi
,
P.
, and
Alkadhi
,
H.
,
2012
, “
Can Computer Tomography Help Predict Feasibility of Transseptal Puncture After Percutaneous Closure of an Interatrial Septal Communication?
,”
J. Interventional Card. Electrophysiol.
,
34
(
2
), pp.
167
172
.
54.
Verma
,
S.
,
Adler
,
S.
,
Berman
,
A.
,
Duran
,
A.
, and
Loar
,
D.
,
2011
, “
Localization of Fossa Ovalis and Brockenbrough Needle Prior to Left Atrial Ablation Using Three-Dimensional Mapping With EnSite Fusion™
,”
J. Interventional Card. Electrophysiol.
,
30
(
1
), pp.
37
44
.
55.
Schernthaner
,
C.
,
Danmayr
,
F.
,
Daburger
,
A.
,
Eichinger
,
J.
,
Hammerer
,
M.
, and
Strohmer
,
B.
,
2013
, “
High Incidence of Echocardiographic Abnormalities of the Interatrial Septum in Patients Undergoing Ablation for Atrial Fibrillation
,”
Echocardiography
,
30
(
4
), pp.
402
406
.
56.
Jayender
,
J.
,
Patel
,
R. V.
,
Michaud
,
G. F.
, and
Hata
,
N.
,
2011
, “
Optimal Transseptal Puncture Location for Robot-Assisted Left Atrial Catheter Ablation
,”
Int. J. Med. Rob. Comput. Assisted Surg.
,
7
(
2
), pp.
193
201
.
57.
Crystal
,
M. A.
,
Mirza
,
M. A.
, and
Benson
,
L. N.
,
2010
, “
A Radiofrequency Transseptal Needle: Initial Animal Studies
,”
Catheterization Cardiovasc. Interventions
,
76
(
5
), pp.
769
773
.
58.
Feld
,
G. K.
,
Tiongson
,
J.
, and
Oshodi
,
G.
,
2011
, “
Particle Formation and Risk of Embolization During Transseptal Catheterization: Comparison of Standard Transseptal Needles and a New Radiofrequency Transseptal Needle
,”
J. Interventional Card. Electrophysiol.
,
30
(
1
), pp.
31
36
.
59.
Winkle
,
R. A.
,
Mead
,
R. H.
,
Engel
,
G.
, and
Patrawala
,
R. A.
,
2011
, “
The Use of a Radiofrequency Needle Improves the Safety and Efficacy of Transseptal Puncture for Atrial Fibrillation Ablation
,”
Heart Rhythm
,
8
(
9
), pp.
1411
1415
.
60.
Karagöz
,
T.
,
Akın
,
A.
, and
Aykan
,
H. H.
,
2014
, “
NRGTM RF Powered Transseptal Needle: A Useful Technique for Transcatheter Atrial Septostomy and Fontan Fenestration: Report of Three Cases
,”
Bosnian J. Basic Med. Sci.
,
14
(
4
), pp.
259
262
.
61.
McWilliams
,
M. J.
, and
Tchou
,
P.
,
2009
, “
The Use of a Standard Radiofrequency Energy Delivery System to Facilitate Transseptal Puncture
,”
J. Cardiovasc. Electrophysiol.
,
20
(
2
), pp.
238
240
.
62.
Capulzini
,
L.
,
Paparella
,
G.
,
Sorgente
,
A.
,
de Asmundis
,
C.
,
Chierchia
,
G. B.
,
Sarkozy
,
A.
,
Muller-Burri
,
A.
,
Yazaki
,
Y.
,
Roos
,
M.
, and
Brugada
,
P.
,
2010
, “
Feasibility, Safety, and Outcome of a Challenging Transseptal Puncture Facilitated by Radiofrequency Energy Delivery: A Prospective Single-Centre Study
,”
Europace
,
12
(
5
), pp.
662
667
.
63.
Abed
,
H. S.
,
Alasady
,
M.
,
Lau
,
D. H.
,
Lim
,
H. S.
, and
Sanders
,
P.
,
2012
, “
Approach to the Difficult Transseptal: Diathermy Facilitated Left Atrial Access
,”
Heart, Lung Circ.
,
21
(
2
), pp.
108
112
.
64.
Greenstein
,
E.
,
Passman
,
R.
,
Lin
,
A. C.
, and
Knight
,
B. P.
,
2012
, “
Incidence of Tissue Coring During Transseptal Catheterization When Using Electrocautery and a Standard Transseptal Needle
,”
Circ.: Arrhythmia Electrophysiol.
,
5
(
2
), pp.
341
344
.
65.
Uchida
,
B. T.
,
Pavcnik
,
D.
,
Shimohira
,
M.
,
Choi
,
Y. H.
,
Jeromel
,
M.
,
Keller
,
F. S.
, and
Rösch
,
J.
,
2011
, “
New Coaxial Transseptal Needle for Creation of Atrial Septal Defects in Adult Sheep
,”
Cardiovasc. Interventional Radiol.
,
34
(
3
), pp.
620
625
.
66.
Wang
,
Y.
,
Xue
,
Y. M.
,
Mohanty
,
P.
,
Natale
,
A.
,
Li
,
L.
,
Wu
,
W. F.
,
Zhu
,
C. M.
,
Liu
,
H.
,
Zhong
,
G. Q.
, and
Zhu
,
L. G.
,
2012
, “
Dilator Method and Needle Method for Atrial Transseptal Puncture: A Retrospective Study From a Cohort of 4443 Patients
,”
Europace
,
14
(
10
), pp.
1450
1456
.
67.
Giudici
,
M. C.
,
Mickelsen
,
S. R.
,
Bhave
,
P. D.
,
Arteaga
,
R. B.
, and
Iqbal
,
O. J.
,
2015
, “
A Safe, Simple Technique for Transseptal Catheterization
,”
Pacing Clin. Electrophysiol.
,
38
(3), pp.
295
296
.
68.
Katritsis
,
G. D.
,
Siontis
,
G. C.
,
Giazitzoglou
,
E.
,
Fragakis
,
N.
, and
Katritsis
,
D. G.
,
2013
, “
Complications of Transseptal Catheterization for Different Cardiac Procedures
,”
Int. J. Cardiol.
,
168
(
6
), pp.
5352
5354
.
69.
Koermendy
,
D.
,
Nietlispach
,
F.
,
Shakir
,
S.
,
Gloekler
,
S.
,
Wenaweser
,
P.
,
Windecker
,
S.
,
Khattab
,
A. A.
, and
Meier
,
B.
,
2014
, “
Amplatzer Left Atrial Appendage Occlusion Through a Patent Foramen Ovale
,”
Catheterization Cardiovasc. Interventions
,
84
(
7
), pp.
1190
1196
.
70.
Chierchia
,
G.-B.
,
Casado-Arroyo
,
R.
,
de Asmundis
,
C.
,
Rodriguez-Manero
,
M.
,
Sarkozy
,
A.
,
Conte
,
G.
,
Sieira
,
J.
,
Levinstein
,
M.
,
Baltogiannis
,
G.
, and
Di Giovanni
,
G.
,
2013
, “
Impact of Transseptal Puncture Site on Acute and Mid-Term Outcomes During Cryoballoon Ablation: A Comparison Between Anterior, Medial and Posterior Transatrial Access
,”
Int. J. Cardiol.
,
168
(
4
), pp.
4098
4102
.
71.
Haegeli
,
L. M.
,
Wolber
,
T.
,
Ercin
,
E.
,
Altwegg
,
L.
,
Krasniqi
,
N.
,
Novak
,
P. G.
,
Sterns
,
L. D.
,
Brunckhorst
,
C. B.
,
Lüscher
,
T. F.
, and
Leather
,
R. A.
,
2010
, “
Double Transseptal Puncture for Catheter Ablation of Atrial Fibrillation: Safety of the Technique and Its Use in the Outpatient Setting
,”
Cardiol. Res. Pract.
,
2010
p.
295297
.
72.
Medi
,
C.
,
Evered
,
L.
,
Silbert
,
B.
,
Teh
,
A.
,
Halloran
,
K.
,
Morton
,
J.
,
Kistler
,
P.
, and
Kalman
,
J.
,
2013
, “
Subtle Post-Procedural Cognitive Dysfunction After Atrial Fibrillation Ablation
,”
J. Am. Coll. Cardiol.
,
62
(
6
), pp.
531
539
.
73.
Feld
,
G. K.
, and
Yao
,
B.
,
2014
, “
Evaluation of the Safety and Effectiveness of the CryoMedix Cryoablation Catheter System for the Treatment of Atrial Flutter and Fibrillation
,”
J. Interventional Card. Electrophysiol.
,
39
(
1
), pp.
37
44
.
74.
De Ponti
,
R.
,
Marazzi
,
R.
,
Picciolo
,
G.
, and
Salerno-Uriarte
,
J. A.
,
2010
, “
Use of a Novel Sharp-Tip, J-Shaped Guidewire to Facilitate Transseptal Catheterization
,”
Europace
,
12
(
5
), pp.
668
673
.
75.
Krijthe
,
B. P.
,
Kunst
,
A.
,
Benjamin
,
E. J.
,
Lip
,
G. Y.
,
Franco
,
O. H.
,
Hofman
,
A.
,
Witteman
,
J. C.
,
Stricker
,
B. H.
, and
Heeringa
,
J.
,
2013
, “
Projections on the Number of Individuals With Atrial Fibrillation in the European Union, From 2000 to 2060
,”
Eur. Heart J.
,
34
(
35
), pp.
2746
2751
.
76.
Taramasso
,
M.
,
Maisano
,
F.
,
Latib
,
A.
,
Denti
,
P.
,
Guidotti
,
A.
,
Sticchi
,
A.
,
Panoulas
,
V.
,
Giustino
,
G.
,
Pozzoli
,
A.
, and
Buzzatti
,
N.
,
2014
, “
Conventional Surgery and Transcatheter Closure Via Surgical Transapical Approach for Paravalvular Leak Repair in High-Risk Patients: Results From a Single-Centre Experience
,”
Eur. Heart J.–Cardiovasc. Imaging
,
15
(
10
), pp.
1161
1167
.
77.
Baldus
,
S.
,
Schillinger
,
W.
,
Franzen
,
O.
,
Bekeredjian
,
R.
,
Sievert
,
H.
,
Schofer
,
J.
,
Kuck
,
K. H.
,
Konorza
,
T.
,
Möllmann
,
H.
, and
Hehrlein
,
C.
,
2012
, “
MitraClip Therapy in Daily Clinical Practice: Initial Results From the German Transcatheter Mitral Valve Interventions (TRAMI) Registry
,”
Eur. J. Heart Failure
,
14
(
9
), pp.
1050
1055
.
78.
Reddy
,
V. Y.
,
Holmes
,
D.
,
Doshi
,
S. K.
,
Neuzil
,
P.
, and
Kar
,
S.
,
2011
, “
Safety of Percutaneous Left Atrial Appendage Closure Results From the Watchman Left Atrial Appendage System for Embolic Protection in Patients With AF (PROTECT AF) Clinical Trial and the Continued Access Registry
,”
Circulation
,
123
(
4
), pp.
417
424
.
79.
Rana
,
B. S.
,
Shapiro
,
L. M.
,
McCarthy
,
K. P.
, and
Ho
,
S. Y.
,
2010
, “
Three-Dimensional Imaging of the Atrial Septum and Patent Foramen Ovale Anatomy: Defining the Morphological Phenotypes of Patent Foramen Ovale
,”
Eur. J. Echocardiography
,
11
(
10
), pp.
i19
i25
.
80.
Gard
,
J.
,
Swale
,
M.
, and
Asirvatham
,
S.
,
2011
, “
Transseptal Access for the Electrophysiologist: Anatomic Considerations to Enhance Safety and Efficacy
,”
J. Innovations Card. Rhythm Manage
,
2
, pp.
332
338
.
81.
Kautzner
,
J.
, and
Peichl
,
P.
,
2012
, “
The Role of Imaging to Support Catheter Ablation of Atrial Fibrillation
,”
Cor Vasa
,
54
(
6
), pp.
e375
e385
.
82.
Sy
,
R. W.
,
Klein
,
G. J.
,
Leong-Sit
,
P.
,
Gula
,
L. J.
,
Yee
,
R.
,
Krahn
,
A. D.
, and
Skanes
,
A. C.
,
2011
, “
Troubleshooting Difficult Transseptal Catheterization
,”
J. Cardiovasc. Electrophysiol.
,
22
(
6
), pp.
723
727
.
83.
Tzeis
,
S.
,
Andrikopoulos
,
G.
,
Deisenhofer
,
I.
,
Ho
,
S. Y.
, and
Theodorakis
,
G.
,
2010
, “
Transseptal Catheterization: Considerations and Caveats
,”
Pacing Clin. Electrophysiol.
,
33
(
2
), pp.
231
242
.
You do not currently have access to this content.