Echocardiography in the invasive laboratory: Utility of two-dimensional echocardiography in performing transseptal catheterization

David G. Hurrell, Rick A. Nishimura, John D. Symanski, David R. Holmes

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Objective: To evaluate the potential utility of trans-thoracic two- dimensional echocardiography as an aid in the technique of transseptal catheterization. Design: We performed a prospective study of 58 patients (29 men and 29 women; mean age, 64.2 years) referred for cardiac catheterization, in whom a systemic approach was used with selective application of two- dimensional echocardiography. Material and methods: The study group of 58 patients had the following diagnoses: mitral stenosis in 17, hypertrophic cardiomyopathy in 13, dilated cardiomyopathy in 13, aortic stenosis in 13, and prosthetic valve dysfunction and pulmonary hypertension in 1 each. With use of only flouroscopic guidance, initial gentle pressure on the ailator alone was attempted for left atrial access. If the catheter resisted entry into the left atrium, two-dimensional echocardiography was performed to assess the catheter's position relative to the atrial septum, and adjustments were made accordingly. Transseptal puncture with a Brockenbrough needle was performed only after confirmation of the catheter position at the region of the fossa ovalis with two-dimensional echocardiography. Results: The catheterization procedure was performed without complication in all 58 patients; the mean time to catheter placement was 5.6 ± 3.5 minutes (range, 3 to 20). Two-dimensional echocardiography was used in 33 patients (57%) when left atrial access was not obtained. On the basis of echocardiographic images, the transseptal catheter had to be repositioned in 16 of these 33 patients (48%). Conclusions: Two-dimensional echocardiography offers value in demonstrating catheter position during transseptal catheterization and may be used in some patients to ensure transseptal puncture at the region of the fossa ovalis.

Original languageEnglish (US)
Pages (from-to)126-131
Number of pages6
JournalMayo Clinic proceedings
Volume73
Issue number2
DOIs
StatePublished - Jan 1 1998

ASJC Scopus subject areas

  • Medicine(all)

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