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

This JSCAI journal CME activity is designed for the article, “SCAI Position Statement on Intracardiac Echocardiography to Guide Structural Heart Disease Interventions.” The field of structural heart disease (SHD) interventions is rapidly expanding, driven by innovations in device technology, advancements in imaging techniques, and the growing expertise of specialized teams. Concurrently, the demand for minimally invasive procedural imaging is increasing with the introduction of new transcatheter therapies for tricuspid regurgitation and the rising adoption of left atrial appendage closure (LAAC) for stroke prevention. Intracardiac echocardiography (ICE) has been used by physicians for decades to guide catheter-based procedures. However, its application in complex valvular interventions was previously limited due to hardware and software constraints. While transesophageal echocardiography (TEE) remains a staple for guiding transcatheter SHD interventions, several factors are driving a greater role for physician-led intraprocedural ICE imaging. Distorted cardiac anatomy, intracardiac shadowing, and the esophagus’s position relative to cardiac structures can restrict TEE imaging windows, necessitating the use of ICE for better visualization. Additionally, the shift towards minimally invasive transcatheter procedures has led medical teams and patients to prefer avoiding general anesthesia and intubation, typically required for TEE.