Related Experiment Video
Updated: Jun 16, 2025

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Transesophageal Echocardiography and Intracardiac Echocardiography to Guide EVOQUE
Nishath Quader1, Tsuyoshi Kaneko2, Noah Williford1
1Division of Cardiovascular Medicine, Washington University School of Medicine, St Louis, Missouri, USA.
Objective:
We demonstrate a step-by-step intraprocedural imaging guide using transesophageal echocardiography (TEE) and intracardiac echocardiography (ICE) to guide EVOQUE in cases with poor intraprocedural imaging.
Key Steps:
ICE right ventricular (RV) inflow/outflow view with biplane along with 3-dimensional (3D) multiplanar reconstruction (MPR). TEE gastric views for wire placement. ICE 3D MPR to guide delivery system and device depth. Anchors to leaflet relationship; adequate leaflet capture using 3D ICE. Confirm posterior leaflet capture using 2-dimensional (2D) and 3D TEE gastric images. Atrial and ventricular expansion of device using 3D and 2D ICE. 3D MPR ICE to guide wire out of the RV. Assess final results.
Potential Pitfalls:
Frame rate of 3D MPR on ICE is lower than that of TEE, cost of ICE catheters, lack of reimbursement for ICE.
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