Structural Heart Imaging Using 3-Dimensional Intracardiac Echocardiography: JACC Cardiovascular Imaging Position Statement.

3-dimensional (3D) intracardiac echocardiography (ICE) is emerging as a promising complement and potential alternative to transesophageal echocardiography for imaging guidance in structural heart interventions. To establish standardized practices, our multidisciplinary expert position statement serves as a comprehensive guide for the appropriate indications and utilization of 3D-ICE in various structural heart procedures. The paper covers essential aspects such as the fundamentals of 3D-ICE imaging, basic views, and workflow recommendations specifically tailored for ICE-guided structural heart procedures, such as transeptal puncture, device closure of intracardiac structures, and transcatheter mitral and tricuspid valve interventions. Current challenges, future directions, and training requirements to ensure operator proficiency are also discussed, thereby promoting the safety and efficacy of this innovative imaging modality to support expanding its future clinical applications.

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Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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Funding Support and Author Disclosures Dr Tang has received speaker honoraria and served as a physician proctor, consultant, advisory board member, transcatheter aortic valve replacement publications committee member, APOLLO (Transcatheter Mitral Valve Replacement With the Medtronic Intrepid™ TMVR System in Patients With Severe Symptomatic Mitral Regurgitation) trial screening committee member, and IMPACT MR steering committee member for Medtronic; has received speaker honoraria and served as a physician proctor, consultant, advisory board member, and the TRILUMINATE (Trial to Evaluate Treatment With Abbott Transcatheter Clip Repair System in Patients With Moderate or Greater Tricuspid Regurgitation) anatomical eligibility and publications committee member for Abbott Structural Heart; has served as an advisory board member for Boston Scientific and Jena-Valve; has served as a consultant for NeoChord, Shockwave Medical, Peija Medical, and Shenqi Medical Technology; and has received speaker honoraria from Siemens Healthineers. Dr Hahn has received speaker fees from Abbott Vascular, Edwards Lifesciences, and Philips Healthcare; and has institutional consulting contracts (for which she has received no direct compensation) with Abbott Vascular, Boston Scientific, Edwards Lifesciences, Medtronic, and Novartis. Dr Alkhouli has served as a consultant to Boston Scientific and Abbott. Dr Aman has served on the advisory board for Abbott Structural Heart, as a consultant for Abbott Structural Heart and Philips, and on the speaker bureau for Abbott Structural Heart and Philips. Dr Berti has been a proctor for Abbott, St. Jude, and Edwards. Dr Chadderdon has received consulting fees from Medtronic and Edwards Lifesciences; and has received grant support from Medtronic and GE Healthcare. Dr Fam has been a consultant to Edwards Lifesciences, Abbott, and Cardiovalve. Dr Ho has served as a consultant for NeoChord. Dr Kliger has been a consultant and has received speaker honoraria from Edwards Lifesciences, Medtronic, and Siemens. Dr Kodali has received consultant fees from Admedus and Dura Biotech; holds equity in Dura Biotech, Microinterventional Devices, Thubrikar Aortic Valve, Supira, Admedus, TriFlo, and Anona; and has received institutional grant support from Edwards Lifesciences, Medtronic, Abbott Vascular, Boston Scientific, and JenaValve. Dr Latib has served on advisory boards or as a consultant for Medtronic, Boston Scientific, Edwards Lifesciences, Abbott, and VDyne. Dr Mahadevan has been a consultant for Edwards Lifesciences. Dr Nair has served as a consultant for and receives honoraria for speaking engagements from Boston Scientific, Johnson and Johnson, and Medtronic. Dr Packer has received research funding from Abbott, Biosense Webster, Boston Scientific/EPT, CardioInsight, EBAmed, Medtronic, NeuCures, Siemens, St. Jude Medical, Thermedical, National Institutes of Health, Robertson Foundation, Vital Project Funds, Xenter, and the Mr and Mrs J. Michael Cook Fund. Dr Praz has received travel expenses from Abbott Vascular, Edwards Lifesciences, and Polares Medical. Dr Rogers has been a consultant for Abbott Structural Heart and Boston Scientific. Dr Ruf has received speaker, consulting, and proctoring fees from Abbott Laboratories and Edwards Lifesciences. Dr Singh has been a consultant for Abbott Structural Heart and Philips. Dr van Mieghem has received research grant support from Abbott Vascular, Boston Scientific, Medtronic, Edwards Lifesciences, Biotronik, Daiichi Sankyo, Abiomed, and PulseCath BV. Dr Vannan has received research grants and speaker honoraria from Piedmont Heart Institute for Abbott, Medtronic, Edwards Lifesciences, Philips, Siemens Healthineers, and GE Healthcare. Dr Yadav has been a consultant and speaker for Edwards Lifesciences, Abbott, Dasi Simulations, and Shockwave Medical. Dr Zahr has received institutional grant support from Edwards Lifesciences and Medtronic. Dr von Bardeleben has been a consultant, advisory board member, TRILUMINATE trial eligibility committee member, and speaker for Abbott Vascular and Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.