Three-Dimensional-Printed Models Reduce Adverse Events of Left Atrial Appendage Occlusion: A Systematic Review and...

Area of Science:

• Cardiology
• Medical Imaging
• Biomedical Engineering

Background:

• Left atrial appendage occlusion (LAAO) is a common procedure for stroke prevention in atrial fibrillation.
• Potential long-term complications include peri-device leak and device-related thrombus.
• Current imaging modalities may have limitations in fully assessing complex left atrial appendage anatomy.

Purpose of the Study:

• To evaluate the efficacy of 3D-printed models in guiding LAAO procedures.
• To determine if 3D-printed model guidance reduces adverse outcomes such as peri-device leak and device-related thrombus.

Main Methods:

• A systematic literature search was performed across PubMed, Google Scholar, and Europe PMC.
• Included studies were cohort studies comparing LAAO with and without 3D-printed model guidance in patients with nonvalvular atrial fibrillation.
• Meta-analysis was conducted using a random-effects model to assess peri-device leak, mismatch, and device-related thrombus.

Main Results:

• Three cohort studies with 204 patients were included in the meta-analysis.
• 3D-printed model guidance was associated with a statistically significant reduction in peri-device leak and mismatch.
• Procedural time was also significantly shorter in the 3D-printed model group; device-related thromboembolism showed a non-significant trend towards reduction.

Conclusions:

• 3D-printed model-guided LAAO demonstrates a lower incidence of peri-device leak and mismatch.
• The findings suggest that 3D modeling can enhance procedural safety and efficacy.
• A large-scale randomized controlled trial is recommended to definitively confirm these benefits.