Intracardiac Echocardiography in Congenital Heart Disease

Abstract

The use of intracardiac echocardiography (ICE) in congenital heart disease has become well established over the past 7 years since its introduction into clinical imaging. The greatest experience has been to guide percutaneous device closures of secundum atrial septal defects and patent foramen ovale, with excellent safety and clinical results. However, ICE has also been used for the evaluation and management of many other congenital heart defects given its unique blood/transducer interface and close proximity to relevant cardiac anatomy. Clinical application of ICE is expanding, with the current ICE catheters being used as micro-transesophageal echo probes, and three-dimensional prototypes already developed and tested in animal models. It is expected that ICE will further increase in use with refinements in technology and greater operator experience, aiding the management of complex congenital heart disease.

Intracardiac echocardiography probe via oesophageal to guide percutaneous left atrial appendage closure procedure: a case series

“…We have tried this technique in three patients considering its feasibility and safety, already reported by its use in children or infants with oropharyngeal abnormalities to guide the repair of congenital heart disease. 12 , 13 …”

“…Instead, the use of the ICE probe via the oesophageal route (ICE-TEE) has not currently been used and validated to monitor LAAC procedure, although it is safe compared to standard TEE in excluding the presence of thrombus in LAA, 10 in guiding percutaneous foramen ovale (PFO) percutaneous closure 11 and in guiding the repair of congenital heart disease. 12 , 13 …”

Intracardiac echocardiography Chinese expert consensus

“…In ASD closure, ICE can accurately measure the diameter of the ASD on multiple views before and after closure device release, assess the length and thickness of ASD edges, such as superior and inferior vena cava edges, anterosuperior edge and superior edge of interatrial septum, and posterior part of diaphragm, and display the relationship between ASD and surrounding structures (right pulmonary vein, coronary sinus, mitral valve, tricuspid valve, etc. ), which is helpful in selecting an appropriate size of closure device and to rule out the possibility of other defects or rare conditions such as venous sinus ASD ( 96 ). Moreover, real-time color Doppler flow monitoring by ICE can be performed intraoperatively to further exclude other potential defects.…”

The role of echocardiography in the management of adult patients with congenital heart disease following operative treatment

“…Although it is not part of the routine clinical practice, and it is available only in specialized laboratories, intracardiac echocardiography is useful in the check-up of arrhythmia developing as a consequence of valve diseases and to explore the anatomy of the heart that has been operated on and modified even for several times. Intracardiac echocardiography may help determining the modified anatomy accompanying a certain arrhythmia substrate, enabling a potentially successful radiofrequency intervention (13). Echocardiography of some common congenital heart diseases will be discussed below.…”