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Cardiology
Intracardiac Echocardiography
Built from Cardiovascular Catheterization and Intervention: A Textbook of Coronary, Peripheral, and Structural Heart Disease
What’s inside
10 sections · 80 slides
Introduction
- Intracardiac echocardiography defined
- Rising demand for procedural echocardiography
- Two-dimensional versus three-dimensional ICE
Anatomic considerations
- Determinants of ICE utility
- Vascular access for ICE
- Near-field imaging principle
- Chamber of choice for each structure
- Volume size, spatial and temporal resolution
- Shadowing and image degradation
Catheters and equipment
- ICE catheter fundamentals
- Commercially available 2D ICE catheters
- Commercially Available 2D Ice Catheters and Compatible Echocardiography Consoles - Part 1
- Commercially available 3D ICE catheters
- Helical-array 3D ICE catheters
- Matrix-array 3D ICE catheters
- Transducer element count against 3D TEE
- Commercially Available 3D Ice Catheters and Compatible Echocardiography Consoles - Part 2
- Asymmetric 3D matrix array and image plane orientation
- Echocardiography console and image tools
- Cath lab set-up requirements
- Operator and staffing requirements
Indications
- General indications for ICE guidance
- Procedures commonly guided by 2D ICE
- Advantages of 3D ICE for transseptal puncture
- Procedures requiring 3D ICE
- 3D ICE as a replacement for 3D TEE
Right atrial imaging
- The right atrial home view
- Standard right atrial views on clockwise rotation
- Clockwise rotation sequence from the home view
- Views obtained on early clockwise rotation
- Posterior structures on continued rotation
- Anterior and posterior flexion in the right atrium
- Effect of anterior and posterior flexion on the imaging plane
- Left and right flexion in 2D ICE
- Aortic valve short-axis views on 2D ICE
- Views essential for septal defect closure
- 2D ICE-guided closure of a patent foramen ovale
Right ventricular and left atrial imaging
- Standard right ventricular ICE views
- Standard right ventricular views on clockwise rotation
- Pericardial assessment from the right ventricle
- Left atrial ICE after transseptal puncture
- Catheter rotation within the left atrium
- Optimising left atrial appendage imaging
- Near-field left atrial appendage imaging from the left atrium
- Intra-aortic ICE from arterial access
Three-dimensional ICE imaging
- Array geometry and image plane orientation
- Optimising biplane alignment for edge-to-edge repair
- Left and right flexion for 3D image optimisation
- The 3D ICE imaging toolset
- Biplane imaging for transseptal puncture
- Biplane imaging for tricuspid edge-to-edge repair
- Live 3D multiplanar reconstruction in practice
- Live 3D multiplanar reconstruction during appendage occlusion
- Live 3D multiplanar reconstruction during tricuspid edge-to-edge repair
Limitations
- Field of view limitations of ICE
- Implications for intracardiac device steering
- Resolution limits compared with TEE
- Cost and single-use catheter design
Special considerations and contraindications
- Knowledge required to use 2D ICE well
- Skills required to use 3D ICE well
- Contraindications to ICE
- Catheter-related risk and monitoring
Conclusions
- Conclusions
- Key points for revision
- References
- References (continued)
- References (continued)
- References (continued)
- Cardiovascular Catheterization and Intervention: A Textbook of Coronary, Peripheral, and Structural Heart Disease
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