Transesophageal and intracardiac echocardiography in therapeutic cardiac catheterizations of structural heart disease

Recently clinical indication of therapeutic cardiac catheterization (CC) is being developed in the field of structural heart disease (SHD) along with the advance and refinement of medical equipment for interventional CC. Echocardiography is an indispensable imaging tool as well as fluoroscopy as a guidance of CC. Transesophageal echocardiography (TEE) is one of the most widely used imaging modalities in diagnosis and treatment of SHD. Although TEE provides high-quality imaging of intra-cardiovascular structures including three-dimensional imaging, it requires general anesthesia when it is performed along with therapeutic CC. Intracardiac echocardiography (ICE) is a useful alternative in this setting since it can be performed intravenously only under local anesthesia during CC and displays excellent cardiovascular imaging similar to TEE. We herein discuss the clinical utility of both TEE and ICE during the procedure of device closure of atrial septal defect.