Abstract
The transseptal Teflon catheter has been successfully advanced into the left atrium without prior needle puncture of the septum in 68 (87%) of 78 patients. It has been possible to do this in the last 58 consecutive patients in this series of 78. A higher level of septal engagement is used than recommended by Ross et al. A patent foramen ovale is present in approximately 25 per cent of adults so that septal perforation by the catheter must have occurred in at least 75 per cent of the patients. Evidence is presented which suggests that no significantly greater septal damage is caused by this maneuver. This modification of the Brockenbrough technic appears to be safe and avoids the risk of the needle snapping out of the left atrium and entering an undesired location, while one is attempting to advance the catheter over the needle into the left atrium.
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