Intracardiac echocardiography during interventional procedures

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Medical Technology

Background:

• Percutaneous cardiac interventions require high-quality imaging for optimal outcomes and complication management.
• Transesophageal echocardiography, the current standard, necessitates general anesthesia and intubation.
• Intracardiac echocardiography (ICE) provides an internal view of cardiac structures, usable by interventional cardiologists.

Purpose of the Study:

• To evaluate the safety and utility of phased array intracardiac echocardiography for various percutaneous cardiac interventions.
• To assess the image quality and impact on patient comfort compared to traditional methods.

Main Methods:

• A phased array, multi-frequency, four-way steerable catheter (AcuNaV) was used in 135 patients.
• ICE was employed during diagnostic catheterization, percutaneous coronary intervention with LV assist device, septal ablation, atrial communication closure, appendage occlusion, valvuloplasty, aortic valve replacement, and pulmonary vein ablation.
• Patient tolerance and procedural complications were meticulously recorded.

Main Results:

• Intracardiac echocardiography was well-tolerated by all 135 patients, with no catheter-related complications.
• Two complications occurred, unrelated to the ICE catheter itself (inferior vena cava and femoral vein dissection due to guidewire/sheath).
• Phased array ICE provided high-quality images facilitating non-surgical interventions.

Conclusions:

• Phased array intracardiac imaging is a safe and effective technology for guiding percutaneous cardiac interventions.
• ICE enhances patient comfort by eliminating the need for general anesthesia.
• This imaging modality optimizes procedural results and aids in complication detection.