The Role of Intracardiac Echocardiography (ICE) to Guide Structural Heart Interventions.
The Role of Intracardiac Echocardiography (ICE) to Guide Structural Heart Interventions.
Source: JSCAI – SCAI Position Statement, October 7, 2025
Keynotes
1. Purpose:
• The Society for Cardiovascular Angiography and Interventions (SCAI) released a new position statement highlighting the expanding role of intracardiac echocardiography (ICE) in structural heart interventions (SHD).
2. Definition – Structural Heart Disease (SHD):
• It refers to abnormalities in the anatomy or structure of the heart, either congenital or acquired, involving the valves, septa, or cardiac chambers.
• In this context, structural heart interventions refer to catheter-based, minimally invasive procedures—such as TAVR, MitraClip/TMVR, and ASD/PFO or LAA closure without open-heart surgey.
3. Clinical Value of ICE:
• ICE provides real-time, high-resolution intracardiac imaging to guide catheter-based interventions precisely and safely.
• It helps physicians visualize cardiac anatomy and device positioning during the procedure without needing general anesthesia.
4. Advantages Over TEE:
• TEE may have limited imaging windows due to patient anatomy or esophageal position and requires intubation and general anesthesia.
• ICE overcomes these challenges, allowing minimally invasive procedures under conscious sedation with excellent visualization.
5. Procedural Applications:
• ICE plays a vital role in:
• ASD/PFO closure
• Mitral and pulmonary valve interventions
• Left atrial appendage (LAA) closure
• It helps detect complications such as paravalvular leak, leaflet dysfunction, or pericardial effusion.
7. Implementation Guide:
• The statement includes a practical roadmap for centers adopting ICE, covering:
• Training and credentialing