In relation to TSP, what risk is increased with a second puncture?

The correct answer highlights that a second puncture during a transseptal procedure (TSP) elevates the potential for procedural complications. When a second entry point is made, it introduces a range of risks that can affect patient safety and procedural efficacy.

For instance, the anatomy of the heart may not only change with the introduction of additional punctures, but the possibility of damaging surrounding structures, such as blood vessels or cardiac tissue, also increases. This heightened risk is compounded by the potential for introducing air or contaminants into the heart or adjacent areas, which can lead to further procedural complications.

In contrast, other options such as increased stability or decreased trajectory precision do not accurately reflect the implications of a second puncture during TSP. Increased stability may be considered an advantage, but it does not necessarily correlate with a second puncture. Similarly, decreased trajectory precision may occur, but the critical concern remains that a second puncture presents significant risks that must be carefully managed. Lastly, decreased contrast usage does not directly relate to the puncture number or is not a generally accepted outcome of performing additional punctures.

Overall, recognizing that a second puncture raises procedural risk underscores why this option is the correct choice.