Total Heart SimWhat you see
Rotating further clockwise past the aortic root brings the interatrial septum into the near field with the left atrium behind it. The mitral valve and the inflow of the left ventricle open out in the far field, and the left atrial appendage often appears at the edge of the sector.
Why it matters
This is the view that shows the left heart from the right atrium. It is used to orient a transseptal puncture, to follow catheters and sheaths once they cross, and to image the mitral valve during structural procedures.
How to get there
About 2 o'clock (50° clockwise)
Rotate further clockwise past the aortic root until the interatrial septum, left atrium and mitral valve appear.
In the simulator:
- Start from the home view (mid right atrium, neutral).
- Rotate clockwise about 50°, to about 2 o'clock.
- Tilt right (about 20° on the R/L dial).
Clinical uses
- Orientation before and after transseptal puncture.
- Following catheters and sheaths in the left atrium.
- Mitral valve imaging in structural interventions.
Frequently asked questions
How do you get the left atrium and mitral valve view on ICE?
Rotate further clockwise past the aortic root until the interatrial septum, left atrium and mitral valve appear. In the Total Heart Sim model heart: Rotate clockwise about 50°, to about 2 o'clock. Tilt right (about 20° on the R/L dial). Small adjustments either way are normal: anatomy and catheters vary.
References
- Enriquez A, Saenz LC, Rosso R, et al. Use of intracardiac echocardiography in interventional cardiology: working with the anatomy rather than fighting it. Circulation. 2018;137:2278–2294.
- Haloot J, Schurmann P. Electrophysiology laboratory survival guide part 2: introduction to intracardiac echocardiography in the electrophysiology laboratory. US Cardiology Review. 2026;20:e16.
- Alkhouli M, Hijazi ZM, Holmes DR Jr, Rihal CS, Wiegers SE. Intracardiac echocardiography in structural heart disease interventions. JACC Cardiovasc Interv. 2018;11(21):2133–2147.
Educational content; not medical advice. Rotation and deflection values are typical teaching values in the simulator's model heart; real anatomy and catheters vary.
