An ultrasound imager provides for LAA closure guidance. Using ultrasound imaging allows for modeling over time (e.g., throughout a heart cycle). An anatomy model of the LAA over time is used to create a biomechanical model personalized to the patient. The personalized models and a model of one or more closure devices are used to select a closure device for the patient appropriate for the entire heart cycle and to guide placement of the selected closure device during an implantation.