Step 3: reconstruction of aortic valve and left coronary artery.
Panel A: With the ICE catheter positioned at the base of the RVOT with the beam facing upwards the AV is displayed in short-axis view. Aortic cusps (LCC, RCC, NCC) can be reconstructed. When the LM is visualized aortic cusps contours should not be traced (the beam is already cutting at the level of the sinus of Valsalva). Panel B:From the same position of Panel A, a slight counterclockwise rotation allows the operator to follow the LM until the bifurcation in LAD and LCX. Multiple contours of these vessels traced in short axis view (with gentle clockwise and counterclockwise torsions) permit the SOUND reconstruction of the coronaries. ICE: intracardiac echocardiography, RVOT: right ventricle outflow tract, AV: aortic valve, LCC: left coronary cusp, RCC: right coronary cusp, NCC: noncoronary cusp, LM: left main, LAD: left anterior descendent (artery), LCX: circumflex (artery).