Key result
Single transseptal puncture matches double puncture with ~100% success while shortening puncture time.
Why the study?
This study aimed to evaluate the effectiveness and safety of transseptal puncture for left-sided catheter interventions and left atrial appendage occluder implantation, and to compare single- versus double-puncture techniques.
Does single-puncture transseptal access improve effectiveness and safety compared to double-puncture techniques in patients undergoing left-sided catheter interventions and left atrial appendage occluder implantation?
Observational (n=775)
Does single-puncture transseptal access improve effectiveness and safety compared to double-puncture techniques in patients undergoing left-sided catheter interventions and left atrial appendage occluder implantation?
Transseptal puncture is an effective and safe method for left heart catheterization with a 100% success rate, where single-puncture techniques reduce puncture time with similar low complication rates compared to double-puncture techniques.
Answers are grounded in this paper and cite their sources.
Single-puncture transseptal access may shorten procedure time with comparable safety; extends Level 3 data but leaves randomized confirmation open.
OBJECTIVE. To evaluate the effectiveness and safety of transseptal access (transseptal puncture, TSP) for left-sided catheter interventions and left atrial appendage occluder implantation, and to compare single- versus double-puncture techniques. MATERIALS AND METHODS. We retrospectively analyzed procedures performed in 2013–2023. Overall, 775 TSPs were performed: group A (n=710) – double TSP under fluoroscopy using an in-house technique; group B (n=38) – single TSP guided by transesophageal or intracardiac echocardiography; group C (n=27) – single TSP under fluoroscopy for high-density mapping-guided ablation. Statistical significance was set at p<0.05.RESULTS. TSP success rate was 100 % across groups. Single puncture reduced puncture time. Early complications (hemopericardium/tamponade, cerebrovascular events, access-site hematoma) were infrequent and did not differ between groups.CONCLUSION. TSP is an effective and safe method for left heart catheterization. Adjunct imaging (TEE/ICE) may improve safety in challenging anatomy.
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Михайлович et al. (2026) conducted an observational in Patients undergoing left-sided catheter interventions and left atrial appendage occluder implantation (n=775). Single transseptal puncture (guided by TEE/ICE or fluoroscopy) vs. Double transseptal puncture under fluoroscopy was evaluated on Transseptal puncture success rate. Transseptal puncture achieved a 100% procedural success rate across single- and double-puncture groups, with single puncture reducing puncture time and showing similar infrequent complication rates.
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