Echocardiographic-Fluoroscopic Fusion Imaging in Transseptal Puncture: A New Technology for an Old Procedure

Francesco F. Faletra, Luigi Biasco, Giovanni Pedrazzini, Marco Moccetti, Elena Pasotti, Laura Anna Leo, Giorgio Cautilli, Tiziano Moccetti, Mark J. Monaghan

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    31 Citations (Scopus)


    In an era of catheter-based structural heart disease and left-side electrophysiologic interventions, transseptal puncture (TSP) is probably the most common transcatheter procedure. Experienced interventional cardiologists and electrophysiologists may safely perform TSP using fluoroscopic guidance alone. However, at present TSP is usually the first step in complex percutaneous catheter-based structural heart disease procedures and necessitate a precise site-specific TSP. Thus, in these procedures most interventional cardiologists perform TSP under fluoroscopic and two- or three-dimensional transesophageal echocardiographic guidance. The EchoNavigator system may provide a solution by fusing fluoroscopic and transesophageal echocardiographic images. In this review, the authors describe advantages and limitations of this new imaging system in guiding TSP and suggest specific echocardiographic-fluoroscopic fusion imaging perspectives that may facilitate TSP, making it potentially easier and safer.
    Original languageEnglish
    JournalJournal of The American Society of Echocardiography
    Publication statusE-pub ahead of print - 7 Jun 2017


    • Catheter-based structural heart disease interventions
    • Transseptal puncture
    • Fluoroscopy
    • Transesophageal echocardiography
    • Echocardiographic-fluoroscopic fusion imaging


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