Transesophageal echocardiographically guided atrial transseptal catheterization in patients with normal‐sized atria: Incidence of complications

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Abstract
The incidence of cardiac complications from atrial transseptal catheterization has never been quantified in patients with normal‐sized atria. Series defining the complication rate are derived from diseased hearts with structural changes that may alter the complication rate of the procedure. The generation of a standardized incidence of perforation in a population of structurally normal atria has important implications. A total of 46 atrial transseptal catheterizations guided by transesophageal echocardiography (TEE) for radiofrequency ablation of left‐sided accessory pathways was performed in 42 patients during a 3‐year period (1990–1993). Clinical and echocardiographic data were analyzed, with special attention given to TEE reports pre‐ and post‐transseptal catheterization. Only one complication occurred in the 46 procedures (2.2%): a perforation of the left atrium that led to pericardial effusion and cardiac tamponade. In a small series of patients with normal sized atria, we have demonstrated that TEE‐guided transseptal catheterization is a procedure with a low complication rate.