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Practice Your Left Atrial Access

The module provides practice for left atrial access via the intra-atrial septum (fossa ovalis) using a correct and safe puncture technique, under fluoroscopic and echocardiographic guidance. During the simulation, life-threatening complications such as pericardial effusion or aortic puncture will need to be attended to. The module includes 11 cases, presenting patient anatomies that vary in the coronary sinus, right atrium, and aorta location and in fossa ovalis size, stiffness, and location. The procedure can be performed with ultrasound guidance with both ICE and TEE. Case 11 is a self-guided tutorial case that gives step-by-step instructions, including illustrations, images, visual guidance on the fluoro/ultrasound screen and real movies showing procedural steps.

Learning Objectives:

  • To establish intracardiac anatomical orientation under fluoroscopy and Echo
  • To practice the correct and safe transseptal puncture technique
  • To practice ICE catheter manipulation and positioning
  • To practice TEE probe manipulation and positioning
  • To practice tool navigation under TEE and ICE
  • To practice management of complications during transseptal puncture


Electrophysiology, Cardiology, Interventional Cardiology

Trnasseptal_puncture_under_TEE_guidance_Big Transseptal Puncture Under TEE Guidance
Tenting_under_fluoroscopy_and_US_guidance_Big Tenting Under Fluoroscopic and ICE Guidance
Puncturing_the_Fossa_Ovalis_Big Puncturing the Fossa Ovalis

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