{"id":"ce13ed16e358","type":"article","url":"https://hartvaat.nl/2026/05/06/transseptale-punctie-bij-linkshartinterventies-nieuwe-esc-consensus-over-technie/","title":"Transseptale punctie bij linkshartinterventies: nieuwe ESC-consensus over techniek, beeldvorming en complicaties","title_en":"Transseptal puncture in cardiovascular interventions: a clinical consensus statement of the European Heart Rhythm Association, the Heart Failure Association, the European Association of Percutaneous Cardiovascular Interventions, the European Association of Cardiovascular Imaging of the ESC, and the Association for European Paediatric and Congenital Cardiology.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euag021","source_url":"https://doi.org/10.1093/europace/euag021","authors":["Isabel Deisenhofer","Magdy Abdelhamid","Marianna Adamo","Nina Ajmone Marsan","Nicolas Amabile","Caterina Bisceglia","Lucas Boersma","Belen Cid Alvarez","Stefano Cornara","Victoria Delgado","Dhiraj Gupta","Ulrich Krause","Philipp Sommer","Stylianos Tzeis","Dan Wichterle","Marta de Riva"],"significance":8,"published":"2026-07-29","source_date":"2026-05-06","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/elektrisch-remodellering-atrium/","https://hartvaat.nl/kennis/atriumfibrilleren/chadsvasc-score/"],"congress":"","summary_en":"A multi-society ESC working group has released a clinical consensus on transseptal puncture (TSP), a foundational technique for over 250,000 annual atrial fibrillation ablations and various structural heart interventions. The statement emphasizes the critical role of echocardiographic guidance for precise fossa ovalis targeting, outlines standardized techniques, and provides clear algorithms for preventing and managing life-threatening complications such as cardiac tamponade and aortic puncture. This consensus offers interventional cardiologists and electrophysiologists a practical, evidence-based framework to enhance procedural safety and outcomes across routine and complex cases.","created":"2026-07-22T01:00:39Z","updated":"2026-08-10T10:38:01Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een internationale werkgroep van de ESC publiceert een klinische consensus over transseptale punctie (TSP), een essentiële stap bij meer dan 250.000 jaarlijkse atriumfibrilleren-ablaties en structurele linkshartinterventies. De richtlijn benadrukt de cruciale rol van echocardiografische beeldvorming voor nauwkeurige targeting van het foramen ovale, beschrijft gevarieerde technieken en geeft concrete protocollen voor het voorkomen en behandelen van complicaties zoals tamponade en aortapunctie. Deze samenvatting biedt cardiologen en EP-specialisten een gestandaardiseerd kader om de procedureveiligheid te optimaliseren in zowel routinematige als complexe casuïstiek.","abstract_original":"With the rapid increase in percutaneous left heart interventions, transseptal access to the left atrium has become a widely used procedure. This technique is crucial for electrophysiological procedures, particularly for atrial fibrillation ablation, which is estimated to be performed in more than 250 000 patients per year worldwide, as well as for various structural heart interventions, like percutaneous mitral valve repair. Although transseptal puncture (TSP) is generally considered a simple technique, it is associated with a small risk of potentially life-threatening complications. To ensure a successful and safe procedure, a thorough understanding of TSPs' clinical use, and the anatomy of the interatrial septum-including the fossa ovalis and its anatomical variants-is critical. Since the first fluoroscopy-guided TSP, advancements in echocardiographic imaging have enhanced the precision of the puncture, allowing targeting of specific regions of the fossa ovalis and facilitating difficult procedures. While most TSPs are performed using a Brockenbrough needle and a (steerable) sheath, wide variation in technique exists, and alternative methods have been developed initially aiming for complex cases but now routinely used. Understanding potential complications-such as cardiac tamponade, aortic puncture, and embolism-is essential for prevention, early recognition, and effective management, ultimately improving patients' outcomes. Finally, understanding how to approach specific complex scenarios is crucial for procedural success."}