How is left atrial appendage closure (LAAC) evolving in 2025—and what’s the role of 3D ICE vs TEE?
In this SWAC session, Dr. Matthew Price and panelists share their real-world experiences and expert pearls:
Why 3D ICE is becoming the standard for Watchman and Amulet procedures
Key tips to avoid air embolism and manage sedation risks
How to safely perform ICE-guided transseptal puncture and LAA imaging
When TEE or mini-TEE probes remain the better option
Cost, staffing, and program scaling strategies for high-volume centers
Practical steps for single-operator workflows and nursing team integration
Whether you’re a structural heart imager, interventional cardiologist, or part of a valve clinic team, this discussion highlights the future of LAAC imaging and what it takes to safely scale programs as patient volumes grow.
00:00 – Welcome & panel introduction
00:18 – Why imaging is critical for LAAC in 2025
00:37 – Matthew Price: 3D ICE is the future for Watchman and Amulet
01:03 – Boston Scientific advisory on air emboli
01:50 – Why 3D ICE outperforms 2D ICE for moderate sedation
02:11 – NCDR registry data on ICE vs TEE outcomes
02:40 – Learning curve and case volume to master ICE
03:42 – Practical workflow: efficient 3D ICE case steps
05:42 – Pre-procedure CT planning and AI sizing tools (FEOPS, DASHI)
07:11 – Tips for safe transseptal puncture with ICE guidance
09:04 – Balloon dilation vs delivery sheath crossing strategies
13:14 – Using fluoro as a backup for ICE alignment
18:08 – Aligning the ICE view to the LAA axis for accurate deployment
28:12 – Preventing air embolism during sedation-only cases
31:18 – Hydration, LA pressure checks, and sheath management
35:17 – When to choose TEE: obesity, severe OSA, or complex mitral work
40:17 – Mini-TEE probes: workflow advantages under MAC
47:01 – Pre-procedural imaging vs on-table imaging debate
52:09 – High-volume GA workflows and 4-minute deployment case
53:08 – Panel takeaways: scaling LAAC imaging programs
#LAAC #Watchman #3DICE #TEE #InterventionalCardiology
#StructuralHeart #CathLab #LAAO #ModerateSedation #MurmurMD