Intra-procedural echocardiography is recommended for all patients undergoing transseptal puncture to provide fundamental insights into septum anatomy and allow for tailored puncture.
This consensus statement provides recommendations for using intra-procedural echocardiography to guide safe and effective transseptal puncture during structural heart interventions.
Interest in the anatomy of the interatrial septum (IAS) and the implications for a proper transseptal puncture (TSP) has risen in the past two decades along with the simultaneous evolution of left-sided transcatheter structural heart interventions. A comprehensive understanding of the anatomy of the IAS in relation with the therapeutic target, is essential for performing a safe and effective transseptal puncture. Intra-procedural echocardiography, transoesophageal and/or intracardiac, is recommended in all patients undergoing TSP because it provides fundamental insights into the septum anatomy and, furthermore, allows for tailored puncture. This document aims to describe the essentials of echocardiographic guidance of transseptal puncture (TSP).
Stella et al. (2026) conducted a review in Transseptal puncture. Intra-procedural echocardiography was evaluated. Intra-procedural echocardiography is recommended for all patients undergoing transseptal puncture to provide fundamental insights into septum anatomy and allow for tailored puncture.
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