Transseptal left heart catheterization with a Swan-Ganz flow-directed catheter: review of 173 studies.

Of 178 transseptal left heart catheterizations performed, 173 successful cases are reported, with the use of a Swan-Ganz, flow-directed, balloon-tipped catheter. By means of a modified Brockenbrough technique, which is described in detail, a 10F Teflon tube (3.3 mm outside diameter) was inserted into the left atrium. Through the tube, which was continuously flushed with saline solution, a 5F Swan-Ganz catheter was introduced into the left atrium. In all cases where left atrial puncture was possible (n = 173), the left ventricle was easily entered, even in the presence of mitral stenosis. Two major complications with signs of cerebral embolism occurred in this series. The method is technically reliable and acceptably safe in cases where the transseptal route of left heart catheterization is required.