Left atrial appendage closure guided by 3D computed tomography printing technology: A case control study

Michele Conti, Stefania Marconi, Giuseppe Muscogiuri, Marco Guglielmo, Andrea Baggiano, Gianpiero Italiano, Maria Elisabetta Mancini, Ferdinando Auricchio, Daniele Andreini, Mark G. Rabbat, Andrea Igoren Guaricci, Gaetano Fassini, Alessio Gasparetti, Fabrizio Costa, Claudio Tondo, Anna Maltagliati, Mauro Pepi, Gianluca Pontone

Research output: Contribution to journalArticle

Abstract

Background: We sought to evaluate the additional value of left atrial appendage (LAA) 3D printing derived from computed tomography (CCT) in determining the size for LAA occlusion (LAAO) devices as compared to standard measurement by using occurrence of LAA leak as endpoint. Methods: We evaluated 6 patients with LAA leak (cases) and 14 matched patients without LAA leak (controls) after LAAO. For each group, a patient-specific 3D printed model of LAA was manufactured using CT pre-operative images. The size recommended by the 3D printed model was compared with the size of the implanted device. Results: Compared to the 3D printed model, 55% of the devices were underestimated, the two sizing approaches agreed in 35% of the patients, while the 3D printed model overestimated the size in 10% of patients. The prevalence of LAA leak was significantly higher in the subset of patients with underestimation of prosthesis implanted with the standard approach as compared to the other patients (p = 0.019). Conclusion: 3D printing of the LAA may provide additional value to standard practice for LAAO device prosthesis sizing with the potential impact to reduce LAA leak.

Original languageEnglish
JournalJournal of Cardiovascular Computed Tomography
DOIs
Publication statusAccepted/In press - Jan 1 2018

Keywords

  • 3D printing technology
  • Atrial fibrillation
  • Percutaneous left atrial appendage closure

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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