The future of interventional cardiology lies in the left atrium.

The historic focus of interventional cardiology has been on treating atherosclerotic coronary artery disease. Balloons, stents, and debulking devices have been the mainstay tools of the interventionalist. However, as engineering skills have developed and clinical techniques have improved, new clinical avenues for the interventionalist beyond the coronary vessels are starting to evolve. One of the most opportunistic areas in cardiology for the interventionalist is the left atrium where treatment of clinically important issues such as mitral regurgitation, left atrial thrombus, atrial fibrillation, patent foramen ovale, and atrial septal defect may be approached. Additionally, the left atrium is a source of important hemodynamic information that can be captured with new implantable devices. While in the past the trans-septal puncture has been infrequently used, the future may hold this technique as one of the most common. The following manuscript describes the status of some of the newest opportunities for interventionalists that lie beyond atherosclerotic disease and within the left atrium.