Cardiac cath
Terms
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- What is a Transseptal Heart Catheterization
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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
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Retrograde left-sided heart cath for aortic or
mitral stenosis or prosthetic valve dysfunction
may not be suitable for or accurate in all
patients. - When is a Transseptal Heart Catheterization indicated?
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Indications
⬢ 1) Conditions that require direct LA or LV
measurement of pressure.
⬢ 2) Access for mitral balloon catheter
valvuloplasty.
⬢ 3) Access for deployment of atrial septal defect
closure devices.
⬢ 4) Prosthetic aortic or mitral heart valve
dysfunction. - When is a Transseptal Heart Catheterization contraindicated?
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Contraindications
• 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?
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transseptal Mullen catheter
Brockenbrough catheter - What is the first step of a transseptal heart cath?
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– 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
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Needle tip for transeptal cath
INFO: - Keeped within the catheter and connected to pressure transducer