Printed MDCT 3D models for prediction of left atrial appendage (LAA) occluder device size: a feasibility study

Selected in EuroIntervention by S. Brugaletta

References

Authors

Goitein O, Fink N, Guetta V, Beinart R, Brodov Y, Konen E, Goitein D, Di Segni E, Grupper A, Glikson M

Reference

EuroIntervention. 2017 May 16

Published

May 2017

Link

Read the abstract

My Comment

Why this study – the rationale/objective?

To assess the feasibility of multi detector computed tomography (MDCT)-based models to predict the correct size of device for left atrial appendage (LAA) occlusion procedures.

How was it executed – the methodology?

Patients planned for LAA occlusion underwent MDCT before implantation, which was used for creating and printing 3D LAA models. Three cardiologists evaluated the 3D models and predicted the correct size of the device by manual manipulation. These predictions were compared with the actual device implanted during the procedure.

What is the main result?

  • Twenty-nine patients were included in this study. AMPLATZER and WATCHMAN devices were deployed in 12 and 17 patients, respectively. Two procedures were aborted due to failure of occlusion; all three physicians predicted it.
  • There was good correlation between the 3D models and the inserted device for AMPLATZER devices with a concordance correlation coefficient of 0.778 (p=0.001) and poor agreement for WATCHMAN devices – concordance correlation coefficient of 0.315 (p=0.203).
  • Agreement among the three physicians for AMPLATZER and WATCHMAN devices was excellent, with a calculated average intra-class correlation of 0.915 and 0.816, respectively.

Critical reading and the relevance for clinical practice

Application of 3D printing in interventional cardiology procedures is somehow fascinating. LAA occlusion procedures may represent an interesting field, as 3D printing may help not only in planning the procedure but also to help those cardiologists who start their LAA program.
The present paper analyses the role of 3D printing in planning the procedure and in particular in choosing the correct device in sizing.
The results, despite limited by the small number of patients, are quite promising. We can bet that 3D printing will be an increasing role in interventional cardiology in the following years.

Do you have any experience in your daily practice? It would be interesting to share it with our community.

No comments yet!