Using cardiographic data to create three-dimensional printed models may allow operators to better perform left atrial appendage (LAA) closures in the case of complex, multi-lobed anatomy, a case study suggested.
A 78-year-old woman with atrial fibrillation and high bleeding risk was admitted for LAA occlusion in Hong Kong. On transesophageal echocardiography (TEE), the anatomy revealed a double-lobed LAA that would be challenging for conventional occluder implantation.
However, after simulating the procedure using a 3D-printed silicon LAA model -- made to measure using the patient’s TEE data -- an ideal implantation strategy for a Watchman LAA closure device became apparent, Alex Pui-Wai Lee, MD, of the Chinese University of Hong Kong, and colleagues reported online in Circulation: Cardiovascular Interventions.
The “complexity and variability of LAA morphology sometimes pose challenges to device implantation, potentially leading to repeated deployment attempts, incomplete seal, procedural complications, and failure,” the researchers wrote.
Now that it is feasible to 3D print patient-specific LAA models using materials that mechanically mimic atrial soft tissues, clinicians may reap the benefits of device simulation and an enhanced appreciation of LAA morphology, they suggested, concluding that the present report “illustrates the techniques and advantages of 3D printing in facilitating LAA occlusion in cases with challenging LAA anatomy.”
Lee disclosed receiving equipment support and a speaker honorarium from Philips Healthcare.
Circulation: Cardiovascular Interventions
Fan Y, et al “Three-dimensional printing for planning occlusion procedure for a double-lobed left atrial appendage” Circ Cardiovasc Interv 2016; DOI: 10.1161/CIRCINTERVENTIONS.116.003561.