Intracardiac echocardiography off piste? Closure of the left atrial appendage using ICE and local anesthesia

Catheter Cardiovasc Interv. 2011 Jan 1;77(1):124-7. doi: 10.1002/ccd.22652.


Left atrial appendage (LAA) occlusion is increasingly accepted to reduce the risk of stroke in patients with atrial arrhythmia who are unsuitable for routine anticoagulation. It is generally performed under general anesthesia, guided by transoesophageal echocardiography with accurate imaging being essential for correct deployment of the device. We present a case where LAA occlusion was done under local anesthesia in a high-anesthetic risk patient, using novel placement of an intracardiac echo probe via a Mullins sheath in the right ventricular outflow tract and pulmonary artery. This allowed accurate visualization of device deployment in the LAA. This technique may increase the spectrum of patients who may benefit from the procedure and decrease procedure time, fluoroscopy, and procedure-related morbidity.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anesthesia, Local*
  • Atrial Appendage / surgery*
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / diagnostic imaging
  • Atrial Fibrillation / surgery*
  • Cardiac Surgical Procedures*
  • Female
  • Humans
  • Stroke / etiology
  • Stroke / prevention & control*
  • Treatment Outcome
  • Ultrasonography, Interventional / methods*