Transseptal left atrial catheterization is routinely used for many
common catheter-based interventions. Tools for transseptal
catheterization have advanced over the recent years. Such tools include
imaging advances with intracardiac echocardiology as well as an array of
needles, wires, and dilators to achieve transseptal access with greater
ease and safety. This review will discuss the contemporary tools for
transseptal catheterization and guidance for difficult cases.