{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T07:13:16Z","timestamp":1761808396885,"version":"3.37.3"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T00:00:00Z","timestamp":1597881600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T00:00:00Z","timestamp":1597881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012364","name":"Baird Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012364","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Ultrasound"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Three-dimensional intracardiac echocardiography (3D ICE) with wide azimuthal elevation is a novel technique performed for assessment of cardiac anatomy and guidance of intracardiac procedures, being able to provide unique views with good spatial and temporal resolution. Complications arising from this invasive procedure and the value of 3D ICE in the detection and diagnosis of acute cardiovascular pathology are not comprehensively described. This case illustrates a previously unreported iatrogenic complication of clot displacement from the intra-vascular sheath upon insertion of a 3D ICE catheter and the value of 3D ICE in immediate diagnosis of clot in transit through the heart with pulmonary embolism.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>We conducted a translational study of 3D ICE with wide azimuthal elevation to guide implantation of a left ventricular assist device (Impella CP\u00ae) in eight adult sheep. A large-bore 14 Fr central venous sheath was used to enable right atrial and right ventricular access for the intracardiac catheter. Insertion of the 3D ICE catheter was accompanied by a sudden severe cardiorespiratory deterioration in one animal. 3D ICE revealed a large highly mobile mass within the right heart chambers, determined to be a clot-in-transit. The diagnosis of pulmonary clot embolism resulting from the retrograde blood entry into the large-bore sheath introducer, rapid clot formation and consequent displacement into venous circulation by the ICE catheter was made. The sheep survived this life-threatening event following institution of cardiovascular support allowing completion of the primary research protocol.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This report serves as a serious warning to the researchers and clinicians utilizing long large-bore sheath introducers for 3D ICE and illustrates the value of 3D ICE in detecting clot-in-transit within right heart chambers.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12947-020-00220-3","type":"journal-article","created":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T16:04:55Z","timestamp":1597939495000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Three-dimensional intracardiac echocardiography and pulmonary embolism"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6668-1545","authenticated-orcid":false,"given":"Konstantin","family":"Yastrebov","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurencie","family":"Brunel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugh S.","family":"Paterson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe A.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul G.","family":"Bannon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,8,20]]},"reference":[{"key":"220_CR1","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1136\/hrt.2004.050443","volume":"91","author":"MRM Jongbloed","year":"2005","unstructured":"Jongbloed MRM, et al. Clinical applications of intracardiac echocardiography in interevntional procedures. Heart. 2005;91:981\u201390.","journal-title":"Heart."},{"key":"220_CR2","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/j.hrthm.2007.01.014","volume":"4","author":"ICK Ho","year":"2007","unstructured":"Ho ICK, et al. Use of intracardiac echocardiography to guide implantation of a left atrial appendage occlusion device (PLAATO). Heart Rhythm. 2007;4:567\u201371. https:\/\/doi.org\/10.1016\/j.hrthm.2007.01.014.","journal-title":"Heart Rhythm"},{"key":"220_CR3","first-page":"1497","volume":"12","author":"JB Masson","year":"2015","unstructured":"Masson JB, et al. Transcatheter left atrial appendage closure using intracardiac echocardiographic guidance from the left atrium. 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