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Improving Left Atrial Appendage Occlusion Device Size Determination by Three-Dimensional Printing-Based Preprocedural
William D Kim1, Iksung Cho2, Young Doo Kim3
1College of Medicine, Chung-Ang University, Seoul, South Korea.
Frontiers in Cardiovascular Medicine
|March 7, 2022
Summary
Three-dimensional (3D)-printed models improve left atrial appendage occluder (LAAO) size determination accuracy. This 3D-printed model implantation simulation offers a more precise method than traditional 2D transesophageal echocardiography (TEE).
Area of Science:
- Cardiovascular Interventions
- Medical Imaging
- Biomedical Engineering
Background:
- Left atrial appendage occluder (LAAO) sizing using 2D transesophageal echocardiography (TEE) is challenging due to anatomical variations.
- Accurate LAAO sizing is crucial for successful percutaneous left atrial appendage occlusion.
Purpose of the Study:
- To compare the accuracy of LAAO size determination using 3D-printed models versus conventional TEE.
- To evaluate the efficacy of 3D-printed model implantation simulations for LAAO device selection.
Main Methods:
- Retrospective review of 28 patients with successfully implanted LAAO devices (Amplatzer Cardiac Plug, Amulet).
- Comparison of LAAO size prediction accuracy between 3D-printed models and TEE measurements.
- Validation against the final implanted LAAO device size.
Main Results:
- 3D-printed left atrium (LA) models closely matched CT-based 3D reconstructions (minimal difference).
- TEE-based sizing showed poor agreement (32.1%) with a mean difference of 2.3 mm.
- 3D-printed model simulation demonstrated excellent correlation (r=0.927) and good agreement (67.9%) with implanted LAAO size, with a mean difference of 0.6 mm.
Conclusions:
- 3D-printed LA models enhance the accuracy of LAAO size determination.
- Implantation simulation using 3D-printed models is superior to the conventional 2D TEE method for LAAO sizing.
