Transseptal Left Heart Catheterization

THE PHYSICIAN who desires to carry out hemodynamic or angiocardiographic studies of the left side of the heart has a large number of technics froim which to choose.1 The ideal method for such investigations should fulfill a number of criteria. First of all, the method must be relatively safe. In order to gain wide acceptaniee it must be technically simple and individuals trained in the standard catheterizationl technies should be able to carry it out without difficulty. The procedure should consistently provide access to both the left atrium and the left ventricle. The investigation should not be associated with undue discomfort for the patien-t and it should be possible to make measurements over prolonged periods of time with the patient in a basal state. The technic should possess sufficient flexibility to be applicable ill all age groups and in patients without cardiovascular disease as well as in those with limited cardiovascular reserve. It should be possible to combine the technic with catheterization of the right side of the heart whenever necessary. Finally, the ideal method of left heart catheterization should also allow injection of contrast material into both the left atrium and the left ventricle for selective anigiocardiography and should permit sampling of blood or of indicator substances in these chambers. As a result of experiences at the National Heart Institute with a variety of methods for measuring pressures in the left side of the heart it is our impression that transseptal left heart catheterization is the procedure that most nearly satisfies these criteria. The purpose of this report is to review the