title: Intracardiac echocardiography during interventional procedures.
abstract: BACKGROUND
  As non-surgical percutaneous interventions are increasingly considered for many cardiac conditions, high quality near field continuous imaging is warranted, in order to optimize the results, and to prevent and detect complications. Transesophageal echocardiography is the standard imaging technique, however general anesthesia and endotracheal intubation is required during prolonged monitoring of percutaneous interventions. Intracardiac echocardiography is a novel emerging tool that allows a view within the cardiac chambers and the large vessels and can be employed by the interventional cardiologist.
  
  
  METHODS
  In our department, a phased array, multi-frequency, four-way steerable catheter (AcuNaV - Siemens) was used for anatomic and haemodynamic cardiac assessment and for guidance and monitoring during non-coronary percutaneous interventions. In total 135 patients underwent intracardiac echocardiographic investigation, 4 during diagnostic heart catheterization, 6 during percutaneous coronary intervention with the use of a new left ventricular assist device, the Impella Recover LP 2.5 system, 26 during percutaneous transluminal septal myocardial ablation (10 patients were reevaluated with intracardiac echocardiography at 6 months), 50 during interatrial communication closure, 4 during percutaneous left atrial appendage transcatheter occlusion, 7 during percutaneous balloon valvuloplasty, 1 during percutaneous aortic valve replacement and 27 during pulmonary vein ablation. All patients tolerated the procedure very well with no catheter related complications. However, there were two complications, which were due to the guidewire and the sheath, an inferior vena cava dissection and a femoral vein dissection, respectively.
  
  
  CONCLUSIONS
  Phased array intracardiac imaging is a safe technology, which facilitates non-surgical interventions by providing high quality images. It eliminates the need for general anesthesia and thus increases the patient comfort.
authors.affiliation: From the Erasmus Medical Center, Thorax center, Rotterdam, The Netherlands.
authors.forename: Sophia
authors.initials: S
authors.lastname: Vaina
authors.forename: Jurgen
authors.initials: J
authors.lastname: Ligthart
authors.forename: Maniyal
authors.initials: M
authors.lastname: Vijayakumar
authors.forename: Folkert J
authors.initials: FJ
authors.lastname: Ten Cate
authors.forename: Maarten
authors.initials: M
authors.lastname: Witsenburg
authors.forename: Luc J
authors.initials: LJ
authors.lastname: Jordaens
authors.forename: George
authors.initials: G
authors.lastname: Sianos
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Thornton
authors.forename: Marcoen F
authors.initials: MF
authors.lastname: Scholten
authors.forename: Peter
authors.initials: P
authors.lastname: de Jaegere
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys