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Cardiac cath


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What is a Transseptal Heart Catheterization
Transseptal access across the thin atrial septal
membrane at the fossa ovalis into the LA and
the LV is an established technique.
WHAT is transseptal heart catherization used to evaluate
Retrograde left-sided heart cath for aortic or
mitral stenosis or prosthetic valve dysfunction
may not be suitable for or accurate in all
When is a Transseptal Heart Catheterization indicated?
⬢ 1) Conditions that require direct LA or LV
measurement of pressure.
⬢ 2) Access for mitral balloon catheter
⬢ 3) Access for deployment of atrial septal defect
closure devices.
⬢ 4) Prosthetic aortic or mitral heart valve
When is a Transseptal Heart Catheterization contraindicated?
• 1) Patients who cannot lie flat.
• 2) Anticoagulant therapy, low platelet count, or
other abnormalities of hemostasis.
• 3) Left or Right atrial thrombus
• 4) IVC mass or obstruction.
• Transseptal left-sided heart cath should be
considered carefully for;
– Patients with distorted cardiac anatomy resulting
from congenital heart disease
– Dilated aortic root
– Marked atrial enlargement
– Thoracic skeletal deformity
In what view a Transseptal Heart Catheterization?
anteroposterior (AP) projection
What two cathaters may be uses for Transseptal Heart Catheterization?
transseptal Mullen catheter
Brockenbrough catheter
What is the first step of a transseptal heart cath?
– 1) A pigtail catheter is placed in the sinus of
Valsalva of the aorta
• For anatomic reference & measurement of AO pressures.
when is crossing of the intraarterial septum is performed in the AP projection?
After the transeptal Mullen Catheter and sheath system of the Brockenbrough catheter has been correctly placed
Step to perform transeptal cath
Insert pigtail catheter is placed in the sinus of Valsalva of the aorta
Why is the pigtail placed in the sinus of Valsalva of the aorta?
For anatomy reference and pressurement
where is the guide wire advance to and from for a transeptal cath
To the SVC via the right femoral vein
Needle tip for transeptal cath
Keeped within the catheter and connected to pressure transducer

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