Transseptal Sheath Technique
Transseptal Sheath Technique - Related Videos
08:00
Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter
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Cited by 18 •
2015
The goal of this study is to demonstrate the preferential location of transseptal puncture during a cryoballoon catheter ablation procedure for the treatment of atrial fibrillation.
06:09
Optic Nerve Sheath Point of Care Ultrasound: Image Acquisition
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Cited by 1 •
2023
Point-of-care ultrasound (POCUS) of the optic nerve sheath diameter (ONSD) has been shown to be useful in identifying patients with increased intracranial pressure (ICP). However, the non-standardized technique for this POCUS has hampered its use. We present a standardized image acquisition protocol for use in the acute care setting.
06:59
Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
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2025
Pulmonary vein stenosis (PVS) is a life-threatening complication of fibrosing mediastinitis (FM), with a poor prognosis if not properly treated. Currently, catheter-based endovascular angioplasty is a promising therapeutic strategy for FM-associated PVS. This protocol primarily outlines a stepwise approach to the transcatheter procedure for FM-associated PVS.
11:21
Robotic Ablation of Atrial Fibrillation
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Cited by 12 •
2015
Pulmonary vein isolation (PVI) with an ablation catheter is a curative treatment for atrial fibrillation (AF). Robotic catheter systems aim to improve catheter steerability. Here, a procedure with a new robotic catheter system is presented. The goal of the procedure is electrical block between pulmonary vein and left atrium.
10:46
Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
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Cited by 4 •
2015
Radiation exposure is an underestimated risk in complex ablation procedures. Here, we describe a protocol to significantly decrease fluoroscopy time and dosage for both the patient and the lab staff by using a novel non-fluoroscopic catheter visualization system.
FAQs
The fossa ovalis serves as the usual passage site because the technique depends on accurately crossing the interatrial septum at a recognized anatomical location. Correct orientation toward this region helps the operator establish the intended route into the left atrium, while fluoroscopic and echocardiographic guidance supports confirmation of positioning before the sheath is advanced.
The transseptal needle creates the opening through the interatrial septum, whereas the specialized sheath is advanced across that opening to maintain a stable catheter pathway. This division of roles allows the initial puncture and subsequent catheter access to occur in a controlled sequence, supporting both diagnostic measurements and therapeutic procedures in the left atrium.
Fluoroscopy provides procedural visualization, and echocardiography can add information about septal position and anatomical orientation. Using these imaging approaches helps guide the needle toward the intended region and confirms the pathway as the sheath crosses the septum. Careful imaging is therefore central to controlled access and to reducing procedural complications.
This catheter-based approach provides left-heart access without open surgery, allowing diagnostic or therapeutic work through a sheath rather than a surgical opening. Its value lies in expanding minimally invasive treatment options, although successful use still depends on precise anatomical orientation, appropriate imaging guidance, and controlled advancement across the interatrial septum.
The procedure begins with imaging and anatomical orientation, followed by positioning a transseptal needle at the intended portion of the interatrial septum. The needle then punctures the septum, and the specialized sheath advances through the opening. Once established, this sheath provides a stable route for diagnostic or therapeutic catheters.
The core components are a transseptal needle, a specialized sheath, and the catheters required for the planned left-heart procedure. Fluoroscopic guidance is used, and echocardiographic guidance may also be included to clarify anatomy and positioning. Together, these tools support controlled septal crossing and stable catheter passage after access is obtained.
Clinicians use this approach when a procedure requires access to the left atrium or other left-sided cardiac structures. Supported applications include atrial fibrillation ablation, measurement of left-sided heart pressures, and structural heart interventions. The technique is especially relevant when these goals can be pursued through minimally invasive catheter access rather than open surgery.
After the sheath crosses the septum, it creates a stable pathway through which catheters can reach the left atrium for measurement, treatment, or structural intervention. Its clinical contribution is not a single outcome but access that enables several procedures, including ablation and pressure assessment, while careful imaging and orientation help maintain procedural control.