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• W4377015428 abstract "Left atrial appendage (LAA) imaging is critical during percutaneous occlusion procedures. 3D-intracardiac echocardiography (ICE) features direct visualization of LAA from multiple cross-sectional planes at a time. To report procedural success of 3D-ICE-guided LAA occlusion and the correlation between pre-procedural transesophageal echocardiography (TEE) and intraprocedural 3D-ICE for LAA sizing. Among 274 patients undergoing LAAO with a Watchman FLX, periprocedural ICE guidance was achieved via a commercially available 2D-ICE catheter (220 patients) or a novel (NUVISION™) 3D-ICE one (54 patients). Technical success was defined as successful device implantation without periprocedural evidence of leaks≥3mm on color Doppler. Procedural success was a composite of technical success plus absence of procedure- or device-related major complications. Primary endpoint was a composite of procedural success and LAA sealing at follow-up TEE. Secondary endpoint was a composite of periprocedural device recapture/resizing plus presence of leaks≥3mm at follow-up TEE. We also compared mean and maximum mean and maximum landing zone (LZ) diameters obtained from same patient’s TEE and 3D-ICE; these measurements were used to assess the degree of correlation and agreement between the two imaging techniques. Procedural success was achieved in all 274 patients; all final devices met release criteria. The agreement between 3D-ICE-based device selection and final device size was 96.3% versus 79.1% with 2D-ICE (p=0.005). No major procedure- and device-related adverse events were documented The incidence of the primary endpoint was 98.1% with 3D-ICE and 97.3% with 2D-ICE (p=0.99). 2D-ICE patients had a trend towards a higher incidence of periprocedural device recapture/redeployment (31.5% vs 44.5%; p=0.09). The secondary endpoint occurred in 31.5% of 3D-ICE patients versus 45.9% of 2D-ICE ones (p=0.065). 3D-ICE measurements of maximum and mean LZ correlated highly with preprocedural TEE reference values [Pearson’s: 0.94; p<0.001; bias: -0.06 (-2.39, 2.27)] (Figure 1). ICE-guided LAAO showed a very high success, with no major adverse events. A very high level of agreement for LAA sizing was found between pre-procedural TEE and periprocedural 3D-ICE. 3D-ICE performed significantly better than 2D-ICE for FLX size selection and may provide better guidance during device deployment." @default.
• W4377015428 created "2023-05-19" @default.
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• W4377015428 date "2023-05-01" @default.
• W4377015428 modified "2023-09-29" @default.
• W4377015428 title "PO-04-065 THREE-DIMENSIONAL INTRACARDIAC ECHOCARDIOGRAPHY FOR LEFT ATRIAL APPENDAGE SIZING AND PERCUTANEOUS OCCLUSION GUIDANCE" @default.
• W4377015428 doi "https://doi.org/10.1016/j.hrthm.2023.03.1110" @default.
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