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

• Published in: Frontiers in cardiovascular medicine 2023-09, Vol.10, p.1188571-1188571
• Main Authors: Heidari, Houtan, Kanschik, Dominika, Erkens, Ralf, Maier, Oliver, Wolff, Georg, Bruno, Raphael Romano, Werner, Nikos, Daniel Reinartz, Sebastian, Antoch, Gerald, Kelm, Malte, Zeus, Tobias, Jung, Christian, Afzal, Shazia
• Format: Article
• Language: English
• Subjects: cardiac computed tomography; Cardiovascular Medicine; device sizing; imaging; left atrial appendage closure; virtual reality
• ISSN: 2297-055X; 2297-055X
• DOI: 10.3389/fcvm.2023.1188571

Background and aimsThe complex and highly variable three-dimensional anatomy of the left atrial appendage (LAA) makes planning and device sizing for interventional occlusion procedures (LAAC) challenging. Several imaging modalities [e.g. echocardiography, multi-slice computed tomography (MSCT)] are used for this purpose. Virtual reality (VR) is an emerging imaging technique to immerse into a three-dimensional left atrium and appendage, offering unprecedented options of visualization and measurement. This study aimed to investigate the feasibility, accuracy and reproducibility of visualizing the LAA in VR for preprocedural planning of LAAC. Methods and resultsTwenty-one patients (79 ± 7 years, 62% male) who underwent LAAC at University Hospital Düsseldorf were included in our study. A dedicated software generated three-dimensional VR models from preprocedural MSCT imaging data. Conventional measurements of LAA dimensions (ostium, landing zone and depth) using a commercially available software were compared to measurements in VR: MSCT and VR ostium min. (r = 0.93), max. (r = 0.80) and mean (r = 0.88, all p