Femtosecond laser technologies have demonstrated substantial clinical potential across diverse medical applications, including ophthalmologic surgery, bone tissue ablation, thrombolysis, dental procedures, and various dermatological interventions [[1], [2], [3], [4], [5], [6], [7]]. Notably, high peak power femtosecond laser enables precise cutting and ablation of tissue in extremely short periods of time, making them promising for accurate transseptal puncture and atrial septostomy in cardiac procedures with minimal collateral damage. However, research specifically addressing this application remains limited and faces significant challenges.

Historically, laser technology in cardiovascular procedures has focused primarily on endocardial ablation and arrhythmia revascularization [[8], [9], [10], [11]]. The potential for its use in minimally invasive transseptal puncture, however, remains underexplored. In clinical settings, transseptal puncture is crucial for various interventional procedures, including electrophysiological ablation, percutaneous mitral valve repair, and left atrial appendage occlusion [[12], [13], [14], [15], [16], [17]]. Despite advancements in devices and techniques that have improved safety and success rates, mechanical puncture methods still carry risks such as myocardial perforation and pericardial tamponade [[18], [19], [20], [21]]. Femtosecond lasers, with their minimal thermal diffusion and precise tissue incision capabilities, present a promising alternative for minimally invasive transseptal puncture and atrial septostomy.

We hypothesized that advanced laser technology, particularly femtosecond lasers, could achieve precise and controlled transseptal puncture and septostomy with minimal thermal damage and high safety. Our study aimed to evaluate the feasibility of using lasers for transseptal puncture through in vitro animal experiments and to assess the associated pathological changes, with the objective of optimizing the technique for laser-assisted atrial septostomy.