Figure 13.
Trans-septal puncture for mitral VIV and VIR. (A) Schematic diagram showing fossa ovalis and the posterior-inferior site of septal puncture (X). (B) X-plane view of trans-septal puncture under TEE, demonstrating posterior-inferior puncture (white arrows). (C) Distance between the puncture and mitral annulus should be at least 3 cm.
