Utility of transesophageal echocardiography in interatrial septal puncture during percutaneous mitral balloon commissurotomy

Academic Article


  • Percutaneous mitral balloon commissurotomy is an alternative to surgical therapy in selected patients with symptomatic mitral stenosis.1 Transseptal cardiac catheterization is the most common approach and complications are rare with experienced personnel but include perforation of the aorta, atria and left ventricular wall.2 Transthoracic 2-dimensional echocardiography has also been used to guide balloon valvuloplasty catheters as well as the transseptal needle across the atrial septum3 but may be limited by an inadequate acoustic window, transducer and catheter images superimposed in the fluoroscopic field and suboptimal atrial septum and fossa ovalis visualization. In contrast, transesophageal echocardiography (TEE) encounters minimal acoustic impedance due to lung or skeletal tissue and yields very high quality images.4 Using TEE, successful visualization of the atrial septum and the membranous portion of fossa ovalis is practically always achieved. The purpose of the current study is to evaluate the usefulness of TEE as an aid to transseptal cardiac catheterization during balloon commissurotomy. © 1990.
  • Authors

    Published In

    Digital Object Identifier (doi)

    Author List

  • Ballal RS; Mahan EF; Nanda NC; Dean LS
  • Start Page

  • 230
  • End Page

  • 232
  • Volume

  • 66
  • Issue

  • 2