MRI-based training model for left atrial appendage closure.

Area of Science:

• Cardiovascular Imaging
• Medical Device Training
• Interventional Cardiology

Background:

• Percutaneous left atrial appendage (LAA) closure is crucial for preventing embolic stroke in atrial fibrillation.
• Optimal transseptal puncture (TSP) site selection is vital but challenging due to variable LAA anatomy.
• Existing training models often lack patient-specific anatomical considerations.

Purpose of the Study:

• To develop a novel, patient-specific training model for percutaneous LAA closure.
• To enable precise identification of the optimal TSP site based on individual LAA morphology.
• To improve training for LAA closure procedures by simulating patient-specific anatomy.

Main Methods:

• Utilized non-contrast-enhanced MRI data to create patient-specific silicone LAA models via 3D printing.
• Developed an MRI-derived 3D-printed base model simulating the atria and multiple TSP sites.
• Connected silicone LAA models to the base model, incorporating a simulated venous access tube for procedural practice.

Main Results:

• Successfully generated patient-specific silicone LAA models from MRI datasets.
• Demonstrated the model's capability to illustrate the impact of TSP site variations on LAA access.
• Validated the technical functionality of the occluder system and catheter handling in simulated scenarios.

Conclusions:

• The proposed MRI-based training model facilitates pre-procedural assessment of TSP site influence on LAA access for patient-specific shapes.
• This radiation-free and contrast-agent-free method is easily replicable using standard clinical imaging and 3D printing.
• The model enhances training for percutaneous LAA closure by addressing anatomical variability.