Which of the following is true about retrograde left atrial access?

• A. It requires crossing the aortic valve and the mitral valve
• B. It uses the arterial system only
• C. It does not involve the aortic valve
• D. It is performed via the inferior vena cava

Answer: (A)

Retrograde left atrial access is done by approaching the heart through the arterial system and moving backward into the left heart. To reach the left atrium from the arterial route, you must cross the aortic valve into the left ventricle and then pass through the mitral valve into the left atrium. That valve-to-valve traversal is what defines this approach.

So, the key point is that entering the left atrium via retrograde access requires crossing both the aortic valve and the mitral valve. It uses an arterial route rather than a venous one, so statements claiming no involvement of the aortic valve or use of the inferior vena cava don’t fit.