ABSTRACT
Between January and August 1991, 37 patients who underwent open mitral valve repair or replacement had left atrial monitoring by a new technique. A percutaneons transvenous line, similar to the one used to measure the central venous pressure, was used to monitor left atrial pressure after penetrating the atrial septum during heart surgery. This technique was useful in the postoperative period for evaluation of the left ventricular function in a similar manner to that obtained by measuring pulmonary capillary wedge pressure. It was also useful in cases of mitral valve repair to evaluate mitral valve function just after the patient is off bypass. Useful information was also obtained after mitral valve replacement. This technique was useful in the postoperative period for evaluation of the left ventricular function in a similar manner to that obtained by measuring pulmonary capillary wedge pressure. It was also useful in cases of mitral valve repair to evaluate mitral valve function just after the patient is off bypass. Useful information was also obtained after mitral valve replacement. Evaluation of the patients before discharge from hospital by colored flow Doppler cardiography was done. In all occasions the septum was intact sand no delectable shunt could be demonstrated. Percutaneous Transseptal left atrial Monitoring [PTLAM] is a simple technique, can be done in all cases in whom the evaluation of left ventricular function is needed; and/or in cases of mitral valve repair or replacement. PTLAM is more accurate than the indirect methods of measuring pulmonary capillary wedge pressure which can be affected by the pressure of pathological changes in the pulmonary vasculature. It also avoids the complications of insertion of Swan Ganz catheter, furthermore it is safer than the use of superior pulmonary vein