Figure 2 :Transesophageal echocardiography at 65 degree shows the large mediastinal tumor compressing the the right ventricular outflow tract and main pulmonary artery. Doppler systolic pressure gradient across the right ventricular outflow tract was 60 mm Hg. (T = tumor mass; Rvot = right ventricular outflow tract; MPA = main pulmonary artery; AoV = aortic valve).