Transseptal System Facilitates Cardiac Chamber Access

A new surgical approach involving transseptal puncture (TSP) and atrial navigation addresses the growing need for precise and efficient access to the left heart chambers.

The Transseptal Solutions (Netanya, Israel) TSP Crosser access system combines a steerable sheath, a dilator, and a flexible puncturing needle into a single integrated system for controlled left atrium access during transseptal catheterization procedures. The flexible puncturing needle and the steerable sheath form a built-in steering mechanism that allows pre-puncture deflection and orientation. During the procedure, a radiopaque loop wire is positioned at the distal end of the sheath to help localize the fossa ovalis.


Once the fossa ovalis is located and the TSO Crosser is positioned in the desired puncturing location, the fossa ovalis can be punctured an the chamber accessed; once inside the left atrium, the sheath can be repositioned up to 180° bidirectionally. The system is indicated for use in a wide variety of procedures where access to the left atrium is desired, including mitral valve repair or replacement, paravalvular leak closure, left atrial appendage (LAA) closure, and electrophysiology (EP) ablation treatment.

“Transseptal catheterization is a critical step for structural heart and electrophysiology interventions. The availability of advanced tools and techniques is essential to perform accurate transseptal puncture as part of challenging LA interventions,” said Elad Sapir, CEO of Transseptal Solutions. “The flexible puncturing needle allows deflection and orientation using the steerable sheath to provide adjustable positioning for puncturing the fossa ovalis and ensuring the TSP Crosser successfully reaches its target location within the left atrium anatomy.”

“There is a growing global demand for trans-septal catheter intervention for patients with structural heart disease,” said Professor Francesco Maisano, MD, head of the cardiovascular surgery department at Zurich University Hospital (Switzerland), and founder of Transseptal Solutions. “The TSP Crosser is an innovative integrated solution addressing the unmet need for precise and controlled transseptal puncture.”

TSP was developed in 1959 to allow direct measurement of left atrial pressure. Over the next several decades, with the growing acceptance of retrograde catheterization of the left ventricle and the expanding use of echocardiography, experience with TSP declined. After introduction of catheter ablation for atrial fibrillation (AF) and percutaneous transcatheter techniques for the treatment of valvular and congenital heart disorders, widespread adoption and further modification of the TSP technique ensued.

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