Latest advances in transseptal structural heart interventions-Percutaneous Mitral Valve Repair and Left Atrial Appendage Occlusion.

Recent advances in structural heart intervention have produced increasing demand for transseptal access, which was first introduced as a diagnostic tool to directly measure left atrial pressure. Transseptal access allows safe and adequate approach to the left atrium and surrounding structures. Percutaneous transcatheter mitral valve repair using the MitraClip device is a safe and less invasive treatment for selected patients with significant mitral regurgitation, who are at high risk for surgery. This is an echocardiographic- and fluoroscopic-guided procedure requiring accurate transseptal access of the left atrium and clipping of the mitral leaflets at the precise location of their malcoaptation. Percutaneous transcatheter closure of the left atrial appendage is another novel procedure that requires transseptal access of the left atrium, followed by closure or ligation of the left atrial appendage. This catheter-based therapy has been shown to be a safe and effective alternative to long-term anticoagulant therapy for the prevention of stroke in patients with atrial fibrillation. In this article, we systematically review these novel structural heart interventions.