Value of radiographic esophagus imaging in determining optimal atrial septal puncture site for percutaneous balloon mitral valvuloplasty

Objectives: To investigate the value of radiographic esophagus imaging in facilitating transseptal catheterization in patients undergoing percutaneous balloon mitral valvuloplasty (PBMV).Methods: A total of 468 patients were randomized into study (radiographic esophagus imaging by oral administration of a contrast media) and control (Ross method) groups.Results: In the study group, the left atrial impression on the esophagus was clearly seen, and was used to identify the right atrial puncture site for the passage of transseptal catheter. In the control group, left atria silhouette was not clearly shown by fluoroscopy in 112 (47.5%) patients. The success rate of transseptal catheterization in the study group was higher than in the control group (99.6% vs 45.7%, P=0.0001). There were no complications in study group but pericardial tamponade occurred in one patient in the control group.Conclusions: Radiographic esophagus imaging facilitates the identification of atrial transseptal puncture site, and improves the success rate for transseptal catheterization in patients undergoing PBMV.