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Updated: Oct 8, 2025
Author Spotlight: Advancements in Intracardiac Echocardiography for Atrial Anatomy Assessment
Published on: June 30, 2023
Computed Tomography-Derived Three-Dimensional Printed Models versus Two-Dimensional Transesophageal Echocardiography
Garly Saint Croix1, Syed Imran Zaidi1, Viky S Loescher2
1Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, FL.
Objective:
This systematic review and meta-analysis compared computed tomography (CT)-derived three-dimensional (3D) modeling versus two-dimensional transesophageal echocardiography (TEE) for left atrial appendage occluder (LAAO) device planning.
Background:
LAAO device planning is commonly performed with TEE. However, procedures often require multiple devices and deployments due to inaccurate sizing from TEE. The use of CT three-dimensional (3D) models for LAAO device planning may improve accuracy.
Methods:
Four clinical studies that reported procedural and clinical outcomes for CT-derived 3D modeling versus TEE for LAAO device planning were identified. End points were accurate device sizing, procedure failure, number of devices used per procedure, fluoroscopy time, and post-procedure leak. Risk ratio (RR) and mean difference (MD) with a 95% confidence interval (CI) were calculated by the Mantel-Haenszel and inverse variance methods.
Results:
A total of 166 participants were included. When compared with conventional imaging, the use of 3D printed models was associated with less fluoroscopy time (MD -6.98 minutes, 95% CI -12.68 to -1.28, p=0.02) and lower risk of occluder device peri-prosthetic leak (RR 0.23, 95% CI 0.07-0.73, p=0.01) for LAAO. There were signals towards lower number of devices per procedure (MD -0.56 devices, 95% CI -1.16-0.05, p=0.07) and less total procedure time (MD -13.50 minutes, 95% CI -28.14-1.14, p=0.07) with printed modeling for LAAO. There was no difference between modalities in rates of procedure failure.
Conclusions:
CT-derived 3D printed models for LAAO device planning may offer the advantages of lower LAAO device peri-prosthetic leak and less fluoroscopy time when compared with conventional TEE guidance.
