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