The Emerging Role of Intracardiac Echocardiography -- Into the ICE Age

Andrew R.J. Mitchell; Prasanna Puwanarajah; Jonathan Timperley; Harald Becher; Neil Wilson; Oliver J. Ormerod


Br J Cardiol. 2007;14(1):31-36. 

In This Article

Other Procedures

There has been work examining the role of ICE to guide closure of perimembranous ventricular septal defects.[12] Similarly, balloon mitral commisurotomy for mitral stenosis can be performed using ICE guidance as reasonable views can be obtained of the mitral valve (figure 6).[13] Our current practice, however, is to continue to use transoesophageal echocardiography (TOE) guidance and general anaesthesia for these procedures as they can be lengthy and the studies, to date, have not demonstrated any clear benefit of ICE.

Figure 6.

Colour-flow echocardiogram of the mitral valve.

In patients with pacemaker lead endocarditis, vegetations can be difficult to visualise with either transthoracic echocardiography or with TOE. ICE can have an important diagnostic role in suspected lead endocarditis, since identifying the size and location of vegetations may determine if lead extraction is indicated whether by a surgical or percutaneous approach.[14] The small size and versatile nature of the ICE probe has led to its use in a wide variety of interesting imaging roles including guiding left ventricular pacing,[15] atrial septal pacing,[16] imaging the aorta using a transnasal approach,[17] evaluation of cardiac function following cardiac surgery via a modified mediastinal chest drain, fetal TOE,[18] guiding septal ablation of hypertrophic cardiomyopathy,[19] diagnosing arrhythmogenic right ventricular cardiomyopathy[20] and guiding the biopsy of cardiac masses.[21,22]


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