A Proposed Maneuver to Guide Transseptal Puncture Using Real-Time Three-Dimensional Transesophageal Echocardiography: Pilot Study

Figure 2

Reducing the gain will remove the blood signals and will allow clear identification of the right atrial structures, for example, SVC opening, IVC opening, Eustachian valve (EV), coronary sinus (CS) opening, and aortic root (Ao). Further gain reduction will cause dropout artifact in the thin area of the fossa ovalis (arrow head) that will help determining its location to guide septal puncture.