Next-Generation Interventional Echocardiography: TEE, ICE, and AI in Transcatheter Structural Heart Procedures

The field of interventional echocardiography is rapidly transforming the care of patients undergoing transcatheter structural heart procedures. With the expansion of therapies such as TAVR, mitral and tricuspid transcatheter repair/replacement, and left atrial appendage occlusion, imaging modalities including transesophageal echocardiography (TEE) and intracardiac echocardiography (ICE) have become indispensable for procedural planning, intraprocedural guidance, and outcome assessment. Advances such as high-resolution 3D/4D imaging, advanced Doppler techniques, and echo-fluoroscopy fusion are elevating the precision and safety of these interventions. Despite this progress, inconsistencies in image acquisition, protocol variability across centers, and the need for reproducible, quantitative assessment remain real challenges for busy interventional heart programs.Artificial intelligence (AI) and machine learning are increasingly explored to standardize imaging, automate measurements, and support procedural workflows. We recognize that most research in this space is still in early stages, and we actively welcome retrospective analyses, pilot feasibility studies, and proof-of-concept algorithms alongside more mature clinical validation work. The goal of this Research Topic is to capture the full spectrum of progress, from early technical development to clinical translation, rather than only fully validated tools.This Research Topic aims to showcase innovation in interventional echocardiography for transcatheter structural and adult congenital heart procedures. We welcome original research, brief research reports, validation studies, state-of-the-art reviews, and consensus or position papers. We are especially keen to hear from clinicians managing day-to-day procedural challenges, not only from specialized imaging or AI research groups.Sub-themes of Interest:• TEE- and ICE-guided transcatheter procedures, including aortic, mitral, and tricuspid interventions, left atrial appendage occlusion, septal and paravalvular defect closure, and adult congenital cases where echo is central• Brief research reports on novel clinical workflows, procedural troubleshooting, or innovative uses of ICE in complex structural procedures• 3D/4D interventional echocardiography innovations, including anatomic rendering, device visualization, and intraprocedural assessment strategies• Quantitative and reproducible measurements for procedural planning and post-deployment evaluation, including inter- and intra-operator reproducibility studies• Standardization and quality improvement: protocol development, checklists, training pathways, educational simulation, and multicenter studies• Fusion imaging and integrated workflows aligning echo-fluoroscopy fusion and multimodality planning with intraprocedural TEE/ICE• Early-stage and validated AI applications in TEE/ICE, including automated view recognition, image quality assessment, automated measurements, and procedural guidance support. Topic editors: Chun Ka Wong, Lam Cheung Chi Simon, Ka-Chun Un Source: https://www.frontiersin.org/research-topics/77233/next-generation-interventional-echocardiography-tee-ice-and-ai-in-transcatheter-structural-heart-procedures