4D Volume Intracardiac Echocardiography for Intraprocedural Guidance of Transcatheter Left Atrial Appendage Closure

Khalili, Houman; Patton, Marquand; Taii, Haider Al; Bansal, Priya; Brady, Matthew; Taylor, Jeanellil; Gurung, Arati; Maini, Brijeshwar

doi:10.4022/jafib.2200

Cited by 20 publications

(20 citation statements)

References 28 publications

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“…Guidance of LAAC with 3D-ICE catheters is feasible, with comparable LAA sizing to 3D-TEE and CCTA. 26,27 Newer low-profile 3D catheters with a broader angle of visualization, standardized workflow, and preprocedural CCTA LAA sizing and planning will…”

Section: Despite the Growing Number Of Laac Procedures In The Unitedmentioning

confidence: 99%

In‐hospital outcomes of transesophageal versus intracardiac echocardiography guided left atrial appendage closure

Morcos

Megaly

Saad

et al. 2022

Cathet Cardio Intervent

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Background: Transesophageal echocardiogram (TEE) is the preferred imaging modality to guide transcatheter left atrial appendage closure (LAAC). Intracardiac echocardiography (ICE) has evolved as a less invasive alternative to TEE. Several observational studies have shown similar success rates and perioperative complications between TEE and ICE for LAAC.Objectives: We sought to examine the temporal trends and patient characteristics of TEE versus ICE use in LAAC using a national database. We also evaluated hospital outcomes including periprocedural complications, mortality, and length of hospital stay.Methods: This is a retrospective analysis of data from the National Readmission Database, collected from 2016 to 2018. The primary outcome was major adverse events (MAE) defined as in-hospital mortality, cardiac arrest, pericardial effusion with or without tamponade, pericardiocentesis or window pericardiocentesis and pericardial window, pericardial effusion and tamponade, and hemorrhage requiring transfusion.Results: Trend analysis showed that TEE-guided LAAC increased from 96.6% in 2016 to 98.4% in 2018 (relative increase, 1.9%), while ICE-guided LAAC decreased from 3.4% to 1.6% during the same period (relative decrease, 53%, p for trend = 0.08). In the unmatched cohorts, the MAE was significantly lower in TEE-guided LAAC compared to ICE-guided LAAC (6.5% vs. 9.3%, p = 0.022). In the propensity score matching analysis, MAE remained significant (5.6% vs. 9.4%, p < 0.001). The incidence of pericardial effusion with or without tamponade remained significantly lower in the TEE group (2.3% vs. 5.8%, p < 0.001). Length of stay (3.4 vs. 1.9 days, p < 0.001) and hospitalization cost ($34,826 vs. $20,563, p < 0.001) remained significantly lower for TEE-guided LAAC.

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Section: Despite the Growing Number Of Laac Procedures In The Unitedmentioning

confidence: 99%

In‐hospital outcomes of transesophageal versus intracardiac echocardiography guided left atrial appendage closure

Morcos

Megaly

Saad

et al. 2022

Cathet Cardio Intervent

Self Cite

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“…Four‐dimensional (4D)‐ICE (real‐time 3D technology) catheters have been introduced as a more novel interventional imaging technique, which has a broader imaging field. It can realize the multi‐plane reconstruction of LAA anatomical structure, allow real‐time observation of the intracardiac structure and blood flow, and provide high‐quality real‐time 3D images 43–45 . Small sample studies have found that 4D‐ICE‐guided LAAC is safe and feasible 45 .…”

Section: The Future Is Promising For Ice‐guided Laacmentioning

confidence: 99%

Can intracardiac echocardiography completely replace transesophageal echocardiography to guide left atrial appendage closure?—The comparisons of intracardiac echocardiography with transesophageal echocardiography

Chen

et al. 2022

Journal of Cardiac Surgery

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Left atrial appendage closure (LAAC) is an effective means of preventing ischemic stroke in patients with nonvalvular atrial fibrillation. Transesophageal echocardiography (TEE) is the primary imaging technique to guide LAAC. Its shortcomings, namely the use of general anesthesia and tracheal intubation, inevitably increase procedural risks. Intracardiac echocardiography (ICE), a novel imaging modality for guiding LAAC, has proven more advantageous over TEE due to use of local anesthesia, shortened procedural time, and reduced radiation exposure. This review highlights the differences between ICE and TEE guided LAAC, aiming to provide a reference for clinical decision-making.

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“…A 14 Fr ICE catheter used in the right atrium only has seen early promise and comparable results to TEE, however the real benefit of ICE over TEE lies in the proximity of the ultrasound transducer to the anatomy of interest, the LAA ostium 3 . This allows higher resolution assessment of the device from the tip of the LAA‐LSPV ridge, or from within the adjacent left sided pulmonary veins.…”

Section: Figurementioning

confidence: 99%

Entering the new ICE age with watchman FLX

Ellis

2021

Cardiovasc electrophysiol

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4D Volume Intracardiac Echocardiography for Intraprocedural Guidance of Transcatheter Left Atrial Appendage Closure

Abstract: The primary drawback of the previous generation of 4D ICE

Cited by 20 publications

References 28 publications

In‐hospital outcomes of transesophageal versus intracardiac echocardiography guided left atrial appendage closure

In‐hospital outcomes of transesophageal versus intracardiac echocardiography guided left atrial appendage closure

Can intracardiac echocardiography completely replace transesophageal echocardiography to guide left atrial appendage closure?—The comparisons of intracardiac echocardiography with transesophageal echocardiography

Entering the new ICE age with watchman FLX

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