Comparison of Intracardiac Echocardiography Versus Transesophageal Echocardiography for Guidance During Transcatheter Aortic Valve Replacement

Figure 1. CONSORT flow diagram. Patients undergoing transfemoral TAVR from August 18, 2015, to June 31, 2021, were included. Among 359 patients eligible for the study, 120 patients were included in each of the matched ICE-MAC and TEE-GA groups based on propensity score matching. CT = computed tomography; GA = general anesthesia; ICE = intracardiac echocardiography; MAC = monitored anesthesia care; TAVR = transcatheter aortic valve replacement; TEE = transesophageal echocardiography; TTE = transthoracic echocardiography.

Figure 2. Time-to-event curves for the primary outcome. Kaplan–Meier curves of the primary outcome for the unmatched groups (A) and matched groups (B) (ICE-MAC vs. TEE-GA). GA = general anesthesia; HR = hazard ratio; ICE = intracardiac echocardiography; MAC = monitored anesthesia care; TEE = transesophageal echocardiography.

Figure 3. Serial echocardiographic assessment before and after TAVR. (A) Bar plots of the incidences of moderate-to-severe PVR assessed by early post-procedural TTE (Post-TAVR; TTE performed within 7 days of the procedure) and 1-year follow-up TTE (1Y-TAVR), with P-values for the comparison between the matched ICE-MAC and TEE-GA groups. (B–D) Boxplots of the median values with interquartile ranges before TAVR (Pre-TAVR), at early post-procedural period (Post-TAVR), and at 1-year after the procedure (1Y-TAVR) for left ventricular ejection fraction (B), mean systolic pressure gradient (C), and effective orifice area (D) for the matched ICE-MAC and TEE-GA groups. GA = general anesthesia; ICE = intracardiac echocardiography; MAC = monitored anesthesia care; PVR = paravalvular regurgitation; TAVR = transcatheter aortic valve replacement; TEE = transesophageal echocardiography.