3D-printed heart model to guide LAA closure: useful in clinical practice?

Objectives: Correct device sizing for left atrial appendage (LAA) closure remains challenging due to complex LAA shapes. The aim of our study was to investigative the utility of personalized 3D-printed models (P3DPM) of the LAA to guide device size selection.Methods: Fifteen patients (75.4 ±8.5years...

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Publicado en:European Radiology Vol. 29; no. 1; pp. 251 - 259
Autores principales: Hachulla, Anne-Lise, Noble, Stéphane, Guglielmi, Gabriel, Agulleiro, Daniel, Müller, Hajo, Vallée, Jean-Paul
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Jan2019
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: 3D-printed heart model to guide LAA closure: useful in clinical practice?
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        au:
          Hachulla, Anne-Lise
          Noble, Stéphane
          Guglielmi, Gabriel
          Agulleiro, Daniel
          Müller, Hajo
          Vallée, Jean-Paul
        affil: Division of Radiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1291, Geneva, Switzerland
      sug:
        subj:
          Atrial Fibrillation Surgery
          Models, Biological
          Printing, Three-Dimensional
          Heart Atrium Surgery
          Female
          Echocardiography, Three-Dimensional
          Middle Age
          Prosthesis Design
          Prostheses and Implants
          Heart Atrium
          Male
          Aged
          Heart Catheterization
          Echocardiography, Transesophageal Methods
          Atrial Fibrillation
          Human
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: Objectives: Correct device sizing for left atrial appendage (LAA) closure remains challenging due to complex LAA shapes. The aim of our study was to investigative the utility of personalized 3D-printed models (P3DPM) of the LAA to guide device size selection.Methods: Fifteen patients (75.4 ±8.5years) scheduled for LAA closure using an Amulet device underwent cardiac computed tomography (CT). The LAA was segmented by semiautomatic algorithms using Vitrea® software. A 1.5-mm LAA thick shell was exported in stereolithography format and printed using TangoPlus flexible material. Different Amulet device sizes on the P3DPM were tested. New P3DPM-CT with the device was acquired in order to appreciate the proximal disc sealing the LAA ostium and the compression of the distal lobe within the LAA. We predicted the device size with P3DPM and compared this with the device sizes predicted by transesophageal echocardiography (TEE) and CT as well as the device size implanted in patients.Results: The device size predicted by 3D-TEE and CT corresponded to the implanted device size in 8/15 (53%) and 10/15 (67%), respectively. The predicted device size from the P3DPM was accurate in all patients, obtaining perfect contact with the LAA wall, without device instability or excessive compression. P3DPM-CT with the deployed device showed device deformation and positioning of the disk in relation to the pulmonary veins, allowing us to determine the best device size in all 15 cases.Conclusion: P3DPM allowed us to simulate the LAA closure procedure and thus helped to identify the best Amulet size and position within the LAA.Key Points: • A 3D-printed heart model allows to simulate the LAA closure procedure. • A 3D-printed heart model allowed to identify the optimal Amulet size and position. • 3D-printed heart models may contribute to reduce the Amulet implantation learning curve.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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