Atrial Transseptal Catheterisation: Challenging Scenarios and Techniques to Overcome Them

Area of Science:

• Cardiology
• Interventional Electrophysiology

Background:

• Atrial transseptal catheterisation is a core competency for interventional electrophysiologists.
• Complex cardiac anatomies present significant challenges to this procedure.

Purpose of the Study:

• To review challenging scenarios in atrial transseptal catheterisation.
• To discuss techniques and tools for safe and feasible procedures in complex cases.

Main Methods:

• Literature review of challenging atrial transseptal catheterisation cases.
• Discussion of specific tools and techniques for complex anatomies.

Main Results:

• Feasibility and safety of transseptal catheterisation in post-surgical/congenital malformations.
• Successful catheterisation despite interatrial septal closure devices.
• Management of absent or obstructed inferior vena cava.
• Transseptal access in complex congenital heart disease post-palliative surgery.

Conclusions:

• Atrial transseptal catheterisation is achievable even in complex cardiac anatomies.
• Dedicated tools and tailored techniques ensure procedural safety and success.