Tejman-Yarden Shai, Freidin Dor, Nagar Netanel, Parmet Yisrael, Abed Muhamed, Vazhgovsky Oliana, Yogev David, Ganchrow Dov, Mazor-Drey Efrat, Chatterji Sumit, Beinart Roy, Barbash Israel, Guetta Victor, Goitein Orly
The Edmond J. Safra International Congenital Heart Center, Sheba Medical Center, Ramat Gan, Israel.
The Engineering Medical Research Lab, Sheba Medical Center, Ramat Gan, Israel.
Heliyon. 2023 Apr 4;9(4):e14790. doi: 10.1016/j.heliyon.2023.e14790. eCollection 2023 Apr.
To explore the feasibility and accuracy of virtual reality (VR) derived from cardiac computed angiography (CCTA) data to predict left atrial appendage occlusion (LAAO) device size.
Retrospective data of patients who underwent LAAO according to clinical indication were reviewed; all patients underwent a pre-procedural CCTA. Measurements of the left atrial appendage (LAA) orifice diameters by CCTA, VR, and transesophageal echocardiography (TEE) (acquired during the procedure) were compared to the implanted device size. The LAA perimeter was calculated using the Ramanujan approximation. Statistical analyses included Lin's Concordance Correlation Coefficient ( ), the mean difference, and the mean square error (MSE).
The sample was composed of 20 patients (mean age 75.7 ± 7.5 years, 60% males) who underwent successful LAAO insertion (ACP™ N = 8, Watchman™ N = 12). The CCTA, VR, and TEE maximal diameter was 0.52, 0.78 and 0.60, respectively with mean differences of +0.92 ± 4.0 mm, -1.12 ± 2.3 mm, and -3.45 ± 2.69 mm, respectively. The CCTA, VR, and TEE perimeter calculations were 0.49, 0.54, and 0.39 respectively with mean differences of +4.69 ± 11.5 mm, -9.88 ± 8.0 mm, and -16.79 ± 7.8 respectively.
A VR visualization of the LAA ostium in different perspectives allows for a better understanding of its funnel-shaped structure. VR measurement of the maximal ostium diameter had the strongest correlation with the diameter of the inserted device. VR may thus provide new imaging possibilities for the evaluation of complex pre-procedural structures such as the LAA.
探讨源自心脏计算机断层血管造影（CCTA）数据的虚拟现实（VR）预测左心耳封堵（LAAO）装置尺寸的可行性和准确性。
回顾根据临床指征接受LAAO治疗的患者的回顾性数据；所有患者均在术前接受了CCTA检查。将CCTA、VR和经食管超声心动图（TEE）（术中获取）测量的左心耳（LAA）开口直径与植入装置尺寸进行比较。使用拉马努金近似法计算LAA周长。统计分析包括林氏一致性相关系数（ ）、平均差和均方误差（MSE）。
样本包括20例患者（平均年龄75.7±7.5岁，60%为男性），他们成功植入了LAAO装置（ACP™8例，Watchman™12例）。CCTA、VR和TEE的最大直径 分别为0.52、0.78和0.60，平均差分别为+0.92±4.0毫米、-1.12±2.3毫米和-3.45±2.69毫米。CCTA、VR和TEE的周长计算值 分别为0.49、0.54和0.39，平均差分别为+4.69±11.5毫米、-9.88±8.0毫米和-16.79±7.8毫米。
从不同角度对LAA口进行VR可视化有助于更好地理解其漏斗状结构。VR测量的最大口直径与植入装置的直径相关性最强。因此，VR可能为评估诸如LAA等复杂的术前结构提供新的成像可能性。
