Author + information
- 1University of Colorado, Denver, Colorado, United States
- 2University of Colorado Hospital, Aurora, Colorado, United States
- 3University of Colorado Health Sciences Center, Aurora, Colorado, United States
- 4Univ Colorado Hospital, Denver, Colorado, United States
- 5University of Colorado Denver, Aurora, Colorado, United States
Procedural planning for left atrial appendage (LAA) closure typically relies on transesophageal echocardiographic and CT measurements for device sizing, and a default C-arm fluoroscopy angle is used for device deployment. However, it is unknown if 3D reconstruction of the LAA and left atrium can improve both device sizing and optimize fluoroscopic imaging.
Patient-specific 3D models of the LAA and relevant surrounding structures were created from CT imaging. From these models, quantitative estimates of LAA dimensions were calculated and used to facilitate device sizing, and optimal angiographic views determined to minimize parallax and foreshortening (Fig 1a, b). We assessed procedural success using 3D modeling for guidance, and differences from the final angiographic to 3D predicted and default (RAO 20, CAU 20) views (Fig 1c).
14 patients were enrolled. Successful device implant (no pericardial effusion or leak <3mm) was achieved in 12 of 14 patients. 3D predicted view was 1.9 ± 2.5 degrees different from the final angiographic view, while default implant view differed by 15±10 degrees.
3-D modeling of LAA with advanced quantitative analyses is safe and effective for procedural planning, and offers customized angiographic views for individual patients. These techniques offer a novel method for procedural planning, enhancing individual case plans and procedural efficiency.
STRUCTURAL: Left Atrial Appendage Exclusion