Interventional imaging: the role of echocardiography

Interventional echocardiography is a rapidly evolving field requiring imaging expertise. An increasing number of structural heart interventions now require real-time imaging guidance for device placement and immediate functional evaluation. Continuous 2- and 3-dimensional transesophageal echocardiography are now required by many heart teams during complex structural interventions, including percutaneous closure of atrial septal defects, left atrial appendage occlusion, transcatheter aortic valve replacement (TAVR), transcatheter repair of paravalvular regurgitation, and percutaneous mitral valve repair. In this review, we describe the role of echocardiography during the initial structural evaluation, throughout the device placement procedure, and for the assessment of acute device function and complications.