A comparison of conventional and advanced 3D imaging techniques for percutaneous left atrial appendage closure

• Published in: Frontiers in cardiovascular medicine 2024-03, Vol.11, p.1328906
• Main Authors: Heidari, Houtan, Kanschik, Dominika, Maier, Oliver, Wolff, Georg, Brockmeyer, Maximilian, Masyuk, Maryna, Bruno, Raphael Romano, Polzin, Amin, Erkens, Ralf, Antoch, Gerald, Reinartz, Sebastian Daniel, Werner, Nikos, Kelm, Malte, Zeus, Tobias, Afzal, Shazia, Jung, Christian
• Format: Article
• Language: English
• Subjects: 3D printing; cardiac computed tomography; Cardiovascular Medicine; left atrial appendage closure; transesophageal echocardiography; virtual reality
• ISSN: 2297-055X; 2297-055X
• DOI: 10.3389/fcvm.2024.1328906

Understanding complex cardiac anatomy is essential for percutaneous left atrial appendage (LAA) closure. Conventional multi-slice computed tomography (MSCT) and transesophageal echocardiography (TEE) are now supported by advanced 3D printing and virtual reality (VR) techniques for three-dimensional visualization of volumetric data sets. This study aimed to investigate their added value for LAA closure procedures. Ten patients scheduled for interventional LAA closure were evaluated with MSCT and TEE. Patient-specific 3D printings and VR models were fabricated based on MSCT data. Ten cardiologists then comparatively assessed LAA anatomy and its procedure relevant surrounding structures with all four imaging modalities and rated their procedural utility on a 5-point Likert scale questionnaire (from 1 = strongly agree to 5 = strongly disagree). Device sizing was rated highest in MSCT (MSCT: 1.9 ± 0.8; TEE: 2.6 ± 0.9; 3D printing: 2.5 ± 1.0; VR: 2.5 ± 1.1;