Radiology

Left atrium

Atrial fibrillation

Interatrial septum

Cardiology

Surgery

Intensive care medicine

Mitral valve

Medicine

International Journal of Cardiology

Transseptal puncture (TSP) was initially described to gain access to the left heart for hemodynamic assessment. Continuous evolution from its origins allows interventionists to perform a myriad of procedures that otherwise would be impossible to accomplish. In the recent years, the number of procedures in cardiology that require TSP has grown exponentially. Namely, transcatheter mitral valve repair and replacement, pulmonary vein isolation and left atrium appendage occlusion. In skilled hands, it is a safe and straightforward procedure; however, a lack of knowledge of the materials, anatomy of the interatrial septum and the technique can be met with life-threatening complications.

Transseptal puncture: Review of anatomy, techniques, complications and challenges, a critical view