Image – Interventional flashlight

DOI: 10.4244/EIJ-D-22-00921

First experience of left atrial appendage occlusion using a 3D mini transoesophageal echocardiographic probe with conscious sedation

Laura Sanchis1,2,3, MD, PhD; Ander Regueiro1,2,3, MD, PhD; Pedro Cepas-Guillén1,2,3, MD, PhD; Marta Sitges1,2,3, MD, PhD; Xavier Freixa1,2,3, MD, PhD

Percutaneous left atrial appendage (LAA) occlusion (LAAO) is an alternative to oral anticoagulation for those patients with atrial fibrillation and a contraindication to or high risk for anticoagulation1. LAAO procedures are typically performed with a 3D imaging technique (transoesophageal echocardiography [TOE] or computed tomography [CT]). For intraprocedural guidance, 3D-TOE is generally used, requiring general anaesthesia in most centres. Technological improvements such as the micro-TOE probe (10T-D; GE Healthcare)2, allow LAAO guidance using only minimal sedation and resulting in same-day patient hospital discharge. However, micro-TOE also has limitations (monoplane imaging, bad visualisation of the far field, need for specialised training, etc.) which limit intraprocedural guidance in complex anatomies or inexperienced centres.

A novel mini TOE probe with 3D capabilities (9VT-D; GE Healthcare) has recently been released on the market for use in the paediatric population (Figure 1A) but with the potential to be used in adults as well. Theoretically, it will maintain the good tolerance of the micro-TOE probe while providing full 3D imaging capabilities. There are additional advantages, as compared to the micro-TOE probe, that include superior...

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Volume 18 Number 17
Apr 24, 2023
Volume 18 Number 17
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