A Technique for Transeptal Left Heart Catheterization via the Right External Jugular Vein

With the aid of right heart catheterization information about the pressure in the left atrium can be obtained indirectly using the catheter in the pulmonary arterial wedge position. For an exact study of diseases within the left chambers of the heart it is important to measure the pressure in the left ventricle and to estimate the pressure gradients across the mitral valve and the left ventricular outflow tract. Several methods for left heart catheterization have been used. Which method one should choose is dependent on the purpose of the examination. For physiological studies the following require-ments should be fulfilled. (1) Catheterization should not cause a marked change of the heart function and it should be possible to define to what extent function has changed. (2) When the catheter has been introduced a steady circulatory state should be obtained before estimating the pressures and the cardiac output. (3) It should be possible to study the haemodynamics during exercise. (4) The procedure should not produce more morbidity than a right heart catheterization. Transbronchial puncture of the left atrium, as described by Facquet, Lemoine, Alhomme, and