Key result
Inadvertent puncture of the anterosuperior plane of the interatrial septum during transseptal access resulted in traversal of the transverse pericardial sinus without significant hemodynamic compromise.
Case Report (n=1)
Highlights the risk of pericardial effusion or cardiac tamponade if transseptal puncture transgresses outside the true atrial septum.
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Demands caution for pericardial entry during transseptal access; leaves open optimal imaging strategies to prevent tamponade.
The interatrial septum is a structure with complex embryological development. The true atrial septum is a circumscribed structure, and transgression outside of this area during transseptal puncture may result in entry into the extracardiac space or aorta that may result in a pericardial effusion or cardiac tamponade. (Level of Difficulty: Intermediate.)
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Pillai et al. (2021) conducted a case report in Paroxysmal atrial fibrillation (n=1). Transseptal puncture was evaluated. Inadvertent puncture of the anterosuperior plane of the interatrial septum during transseptal access resulted in traversal of the transverse pericardial sinus without significant hemodynamic compromise.
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