Left atrial appendage sizing for percutaneous closure in virtual reality-a feasibility study

Area of Science:

• Cardiovascular Imaging
• Medical Technology
• Interventional Cardiology

Background:

• Left atrial appendage (LAA) anatomy is complex and variable, complicating device selection for left atrial appendage occlusion (LAAC).
• Current imaging modalities like echocardiography and multi-slice computed tomography (MSCT) have limitations in visualizing LAA 3D structures.
• Virtual reality (VR) presents a novel approach for immersive 3D visualization and measurement of cardiac anatomy.

Purpose of the Study:

• To evaluate the feasibility, accuracy, and reproducibility of VR for LAA visualization.
• To assess VR's utility in preprocedural planning for LAAC procedures.
• To compare VR measurements with conventional MSCT-based measurements.

Main Methods:

• Twenty-one patients undergoing LAAC were included.
• Three-dimensional VR models were generated from preprocedural MSCT data.
• LAA dimensions (ostium, landing zone, depth) were measured in VR and compared to conventional MSCT measurements.

Main Results:

• Strong correlations were observed between VR and MSCT measurements for ostium and landing zone dimensions (r values ranging from 0.80 to 0.93, p < 0.001).
• Physicians rated the 3D orientation in VR as superior to MSCT (p < 0.05).
• VR visualization demonstrated feasibility and precision for LAA measurements.

Conclusions:

• Virtual reality visualization based on MSCT data is feasible for LAA assessment.
• VR enables precise and reproducible measurements, enhancing 3D orientation for LAAC planning.
• Further research should explore additional benefits of VR for interventionalists.