Centro Hospitalar e Universitário de Coimbra - Hospital Geral, Quinta dos Vales, São Martinho do Bispo 108, 3041-801 Coimbra, Portugal.
Centro Hospitalar e Universitário de Coimbra - Hospital Geral, Quinta dos Vales, São Martinho do Bispo 108, 3041-801 Coimbra, Portugal; Faculdade de Medicina da Universidade de Coimbra, R. Larga 2, Diana de Campos, 3000-370 Coimbra. Portugal.
Int J Cardiol. 2022 Jun 1;356:38-43. doi: 10.1016/j.ijcard.2022.03.042. Epub 2022 Mar 28.
Three-dimensional printing (3D) has emerged as an alternative to imaging to guide left atrial appendage closure (LAAC) device sizing.
We assessed the usefulness of 3D printing compared to a standard imaging-only approach for LAAC.
We identified studies comparing an imaging-only with a 3D printing approach in LAAC. A fixed-effects meta-analysis was performed targeting a co-primary endpoint of disagreement in device sizing and leaks.
Eight studies that assigned 283 participants to an imaging-only approach and 3D printing approach (145 patients) were included. 3D printing significantly reduced the risk of the co-primary endpoint (risk raio (RR) = 0.19; 95% confidence interval (CI) 0.09-0.37), with consistency across the studies (I2 = 0%). Individually, both device size disagreements [RR 0.13 (95% CI 0.06-0.29), P < 0.001] and leaks [RR 0.24 (95% CI 0.09-0.64) P = 0.004] were reduced under a 3D printing modeling strategy.
Compared with an imaging-only strategy, 3D printing is associated with reduction in device size disagreements and leaks.
三维打印（3D）已成为一种替代成像技术的方法，用于指导左心耳封堵（LAAC）装置的尺寸选择。
我们评估了 3D 打印与仅成像方法在 LAAC 中的应用效果。
我们确定了比较仅成像与 3D 打印方法在 LAAC 中应用的研究。针对设备尺寸和漏诊方面的主要终点不一致进行了固定效应荟萃分析。
共有 8 项研究将 283 名患者分为仅成像组和 3D 打印组（145 名患者）。3D 打印显著降低了主要终点不一致的风险（风险比（RR）= 0.19；95%置信区间（CI）0.09-0.37），且各研究间结果一致（I2= 0%）。单独来看，在 3D 打印模型策略下，设备尺寸不一致（RR 0.13；95%CI 0.06-0.29；P<0.001）和漏诊（RR 0.24；95%CI 0.09-0.64；P=0.004）的风险均降低。
与仅成像策略相比，3D 打印可减少设备尺寸不一致和漏诊的发生。
