SCAI Position Statement on Intracardiac Echocardiography to Guide Structural Heart Disease Interventions

As structural heart disease interventions rapidly evolve, demand for minimally invasive intraprocedural imaging techniques has increased. Intracardiac echocardiography (ICE) has emerged as a valuable imaging modality, offering real-time, high-resolution visualization of cardiac structures without the need for general anesthesia. This position statement from the Society for Cardiovascular Angiography & Interventions outlines the clinical applications, advantages, limitations, and implementation strategies for ICE in guiding transcatheter structural heart disease procedures. The document details standardized ICE imaging protocols and views for interventions involving the mitral, tricuspid, and pulmonary valves, as well as left atrial appendage occlusion atrial septal defect, and patent foramen ovale closure. It emphasizes the importance of operator training, physician workflows, and institutional readiness for successful ICE integration. The statement also advocates for updated reimbursement models that reflect the complexity and value of ICE-guided procedures and calls for further research comparing ICE and transesophageal echocardiography outcomes.