Intracardiac echocardiography

Summary

Intracardiac echocardiography (ICE) is used to guide many advanced interventions on structural heart disease, with the goal of decreasing lengthy procedure times, minimising radiation exposure, increasing safety, and facilitating procedural success. Mechanical (rotational or radial) and phased array transducers are the two available imaging systems, and the latter generates images that are similar to transoesophageal echocardiography (TOE). A series of standardised views helps the operator to assess the target anatomy and surrounding cardiac structures, rule out important contraindications to the percutaneous approach not appreciated in prior studies, and deliver therapeutic devices. Closure of interatrial and interventricular septal defects, transseptal puncture, rhythm ablation, and balloon mitral valvuloplasty are some of the more common ICE-guided procedures which are reviewed in this chapter.

Introduction

Percutaneous interventional repair of structural heart disease in the cardiac catheterisation laboratory is becoming more widespread as an alternative to open heart surgery. Proper anatomic assessment is crucial during procedures to confirm the eligibility of the patient for an interventional procedure, guide catheter and device placement, and quickly diagnose any complications. ICE and TOE are two imaging modalities used in the catheterisation laboratory to perform these objectives 11. Silvestry FE, Kerber RE, Brook MM,...