Conscious Sedation LAAO with ICE: Building a Solo-Operator WATCHMAN Program with Dr. Gollapudi

Can you safely perform left atrial appendage occlusion (LAAO) without TEE, anesthesia, or an echo doc?In this episode, Dr. Raghava Gollapudi (San Diego Cardiac Center) and colleagues break down how they built a conscious sedation, ICE-only LAAO program in private practice. They cover:- Why traditional TEE + anesthesia models slow scheduling and add variability- Evidence from Europe showing ICE-only Watchman is safe- How to transition from TEE support to ICE-only workflow- Practical pearls for ICE catheter handling, transeptal crossing, and imaging- Patient selection: absolute and relative contraindications- The role of nursing staff and team buy-in- Why 3D/4D ICE makes device visualization easierThis is a must-watch for operators and program builders looking to simplify workflows and improve access to LAAO.⏱️ Chapters00:00 – Intro & program overview01:00 – Why conscious sedation for LAAO?02:00 – Limitations of TEE + anesthesia model02:45 – Evidence for ICE-only Watchman safety03:30 – Becoming a solo-operator with ICE04:45 – Transition: 20 cases with TEE + ICE06:00 – Patient selection: contraindications & risks08:00 – Screening tools & nursing involvement09:00 – Step-by-step ICE technique & home views10:30 – Transeptal crossing: tips, 3-minute rule12:00 – Biggest barrier: ICE-only septal crossing14:00 – Imaging the appendage: mid & low angle views15:45 – Benefits of 3D/4D ICE vs 2D ICE16:30 – Final pearls for solo-operator LAAO🔔 Subscribe for more insights from interventional experts and real-world program builders.📱 Download the app: https://apps.apple.com/app/apple-stor...#LAAO #Watchman #ConsciousSedation #ICEImaging #InterventionalCardiology #StructuralHeart #CathLab #AtrialFibrillation #SoloOperator #murmurmd