Author + information
- Andrew Roy1,
- Jerome Horvilleur2,
- Bertrand Cormier3,
- Maxime Cazalas4,
- Leticia Fernandez-Lopez5,
- Martina Patanè6,
- Antoinette Neylon7,
- Marco Spaziano8,
- Fadi Sawaya1,
- Erik Bouvier3,
- Thomas Hovasse9,
- Thierry Lefevre10,
- Bernard Chevalier11 and
- Philippe Garot12
- 1ICPS, Paris, France
- 2Ramsay Générale de Santé - ICPS
- 3Hôpital Jacques Cartier
- 4GE Healthcare, Wauwatosa, Wisconsin, United States
- 5Institut Hospitalier Jacques Cartier, Paris, France
- 6Ospedale Ferrarotto, Catania, Catania, Italy
- 7Institut Cardiovasculaire Paris Sud, Paris, France
- 8McGill University Health Center, Montreal, Quebec, Canada
- 9United States
- 10Institut Hospitalier Jacques Cartier, Massy, France
- 11Institut Cardiovasculaire Paris Sud, Massy, France
- 12INSTITUT CARDIOVASCULAIRE PARIS SUD - HOPITAL JACQUES CARTIER, MASSY, France
A successful LAA occlusion procedure relies on multiple imaging modalities, including TEE or 3D-MDCT, and fluoroscopy. Effectively integrating these imaging modalities may improve implantation safety and success. To our knowledge this has not been previously described for LAA occlusions. This is a novel report demonstrating the application and feasibility of novel 3D-MDCT real-time fusion roadmap technology with fluoroscopy, for LAA occlusion procedures.
This observational study compared clinical and procedural parameters for procedures performed with or without fusion integration. All patients had a pre-procedural 3D-MDCT for LAA measurements, along with 3D analyses of LAA morphology and surrounding structures. Using the image fusion software (Valve ASSIST 2, GE Healthcare, UK), landmarks were identified on fluoroscopy, and MDCT LAA anatomy outlines were then projected onto the real-time fluoroscopy image during the procedure, to guide all steps of the intervention.
A total of N=57 patients underwent LAA occlusion, with n=16 performed using the fusion software. In comparison to the pre-fusion group, significant reductions in contrast volume (21.0 ± 11.7 vs 95.9 ± 80.5 mLs, p<0.001), procedure time (63.0 ± 22.0 vs 87.3 ± 43.0 mins, p=0.01) and fluoroscopy time (6.2 vs 8.3 mins, p=0.03) were observed. Incomplete sealing (0% vs 14.6%, p=0.16) and device deployment success (100% vs 92.7%, p=0.17) were not significantly different.
The addition of this novel fusion technology is safe and feasible, and offers a promising addition, or potential alternative, to current imaging modalities for optimizing LAA procedural success.
STRUCTURAL: Left Atrial Appendage Exclusion