Li Huakang, Shu Maoqin, Wang Xueqin, Song Zhiyuan
Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
Department of ultrasound, Southwest Hospital, Third Military Medical University, Chongqing, China.
Int J Cardiol. 2017 Mar 15;231:258-263. doi: 10.1016/j.ijcard.2017.01.031. Epub 2017 Jan 5.
Three-dimensional printing (3DP) has undergone rapid development in medical applications. However, only a few reports have described its applications in left atrial appendage (LAA) occlusion. We assessed the feasibility and effectiveness of the 3DP technology for left atrial appendage (LAA).
Forty-two patients with atrial fibrillation (average age: 69.3±7.8years) were randomly assigned to two groups equally (3DP and control). The transoesophageal echocardiography (TOE), LAA angiography, and cardiac computed tomography angiography measurements of the LAA orifice size between the groups. The procedure times, radiographic exposure, contrast agent volumes, residual shunt and costs were presented between the two groups.
All patients underwent a successful LAA occlusion operation with the Watchman device. TOE, LAA angiography, and cardiac computed tomography angiography measurements of the LAA orifice size between the groups were 20.4±2.5 vs. 20.1±3.3mm, 19.6±2.2 vs. 19.5±2.8mm, and 20.8±2.1 vs. 20.2±3.0mm, respectively (p>0.05). After the occlusion, the immediate TOE examination showed 3 mild residual shunt cases in the control group. The radiation exposure was significantly reduced in the 3DP compared with the control group (p<0.05). The patients were followed for an average of 7.7±2.5months. No postoperative complications, device-related thrombosis, or ischemic events occurred.
LAA occlusion guided by 3DP technology is feasible. 3DP increases the working efficiency and ensures the effectiveness of occlusion, making it valuable for clinical application.
三维打印(3DP)在医学应用中发展迅速。然而,仅有少数报告描述了其在左心耳(LAA)封堵中的应用。我们评估了3DP技术用于左心耳封堵的可行性和有效性。
42例房颤患者(平均年龄:69.3±7.8岁)被随机均分为两组(3DP组和对照组)。比较两组间经食管超声心动图(TOE)、LAA血管造影及心脏计算机断层扫描血管造影测量的LAA开口大小。呈现两组间的手术时间、放射暴露、造影剂用量、残余分流及费用。
所有患者均使用Watchman装置成功完成LAA封堵手术。两组间TOE、LAA血管造影及心脏计算机断层扫描血管造影测量的LAA开口大小分别为20.4±2.5 vs. 20.1±3.3mm、19.6±2.2 vs. 19.5±2.8mm及20.8±2.1 vs. 20.2±3.0mm(p>0.05)。封堵后,即刻TOE检查显示对照组有3例轻度残余分流。与对照组相比,3DP组的放射暴露显著减少(p<0.05)。患者平均随访7.7±2.5个月。未发生术后并发症、与装置相关的血栓形成或缺血事件。
3DP技术引导下的LAA封堵是可行的。3DP提高了工作效率并确保了封堵效果,使其在临床应用中具有价值。