Development and application of transseptal left heart catheterization.

The recent interest in transseptal left heart catheterization affords an opportunity to review the development and application of this procedure. This review briefly follows the history of right and left heart catheterization to the development of the transseptal procedure. A detailed description of the technique of transseptal catheterization is provided, as well as the indications and contraindications to its use. A learning curve is associated with this technique and is inversely related to the complication rate of the transseptal approach. Physicians working in high volume catheterization laboratories may gain the experience to safely perform transseptal left heart catheterization on carefully selected patients.