Cargando…
Applications of low-cost 3D printing in left atrial appendage closure using epicardial approaches – initial clinical experience
INTRODUCTION: Left atrial appendage occlusion procedure (LAAO) became an alternative method for stroke prevention in atrial fibrillation (AF) patients with contraindication or intolerance for oral anticoagulation therapy. However, LAA anatomy is complex with several different types of LAA morphology...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066675/ https://www.ncbi.nlm.nih.gov/pubmed/30069196 http://dx.doi.org/10.5114/kitp.2018.76481 |
_version_ | 1783343008435929088 |
---|---|
author | Litwinowicz, Radoslaw Witowski, Jan Sitkowski, Mateusz Filip, Grzegorz Bochenek, Maciej Michalski, Michal Banaszkiewicz, Krzysztof Urbanczyk-Zawadzka, Malgorzata Banys, Robert Sobczynski, Robert Kapelak, Boguslaw Bartus, Krzysztof |
author_facet | Litwinowicz, Radoslaw Witowski, Jan Sitkowski, Mateusz Filip, Grzegorz Bochenek, Maciej Michalski, Michal Banaszkiewicz, Krzysztof Urbanczyk-Zawadzka, Malgorzata Banys, Robert Sobczynski, Robert Kapelak, Boguslaw Bartus, Krzysztof |
author_sort | Litwinowicz, Radoslaw |
collection | PubMed |
description | INTRODUCTION: Left atrial appendage occlusion procedure (LAAO) became an alternative method for stroke prevention in atrial fibrillation (AF) patients with contraindication or intolerance for oral anticoagulation therapy. However, LAA anatomy is complex with several different types of LAA morphology. Therefore matching the correct size of a delivery device to LAA morphology is difficult. In such circumstances, the 3D-printed model of LAA closure may be useful for preoperative planning which increases the efficacy of LAAO procedure. MATERIAL AND METHODS: We report as a first 2 cases of LAA occlusion procedure using 2 different systems: thoracoscopic AtriClip and the LARIAT device in which a 3D printed LAA model was used in preoperative planning. RESULTS: In the first patient, preoperative measurements of 3D LAA model were performed using a dedicated selection guide for AtriClip device were comparable with the intraoperative examination. Left atrial appendage was closed epicardial using 40 mm size AtriClip. In second patients, LAA closure was performed completely percutaneously using LARIAT device. For better visualization of LAA shape on fluoroscopy and TEE examination, intraoperatively sterilized 3D LAA model was used during the procedure. In both cases, intraoperative TEE examination confirmed complete LAA closure with no leak. CONCLUSIONS: Left atrial appendage 3D model is a useful tool in preoperative planning of a left atrial appendage occlusion using epicardial approaches with thoracoscopic or percutaneous access using LARIAT device. The quality of low-cost 3D printed LAA model is sufficient in planning minimally invasive procedure. |
format | Online Article Text |
id | pubmed-6066675 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-60666752018-08-01 Applications of low-cost 3D printing in left atrial appendage closure using epicardial approaches – initial clinical experience Litwinowicz, Radoslaw Witowski, Jan Sitkowski, Mateusz Filip, Grzegorz Bochenek, Maciej Michalski, Michal Banaszkiewicz, Krzysztof Urbanczyk-Zawadzka, Malgorzata Banys, Robert Sobczynski, Robert Kapelak, Boguslaw Bartus, Krzysztof Kardiochir Torakochirurgia Pol Short Communication INTRODUCTION: Left atrial appendage occlusion procedure (LAAO) became an alternative method for stroke prevention in atrial fibrillation (AF) patients with contraindication or intolerance for oral anticoagulation therapy. However, LAA anatomy is complex with several different types of LAA morphology. Therefore matching the correct size of a delivery device to LAA morphology is difficult. In such circumstances, the 3D-printed model of LAA closure may be useful for preoperative planning which increases the efficacy of LAAO procedure. MATERIAL AND METHODS: We report as a first 2 cases of LAA occlusion procedure using 2 different systems: thoracoscopic AtriClip and the LARIAT device in which a 3D printed LAA model was used in preoperative planning. RESULTS: In the first patient, preoperative measurements of 3D LAA model were performed using a dedicated selection guide for AtriClip device were comparable with the intraoperative examination. Left atrial appendage was closed epicardial using 40 mm size AtriClip. In second patients, LAA closure was performed completely percutaneously using LARIAT device. For better visualization of LAA shape on fluoroscopy and TEE examination, intraoperatively sterilized 3D LAA model was used during the procedure. In both cases, intraoperative TEE examination confirmed complete LAA closure with no leak. CONCLUSIONS: Left atrial appendage 3D model is a useful tool in preoperative planning of a left atrial appendage occlusion using epicardial approaches with thoracoscopic or percutaneous access using LARIAT device. The quality of low-cost 3D printed LAA model is sufficient in planning minimally invasive procedure. Termedia Publishing House 2018-06-25 2018-06 /pmc/articles/PMC6066675/ /pubmed/30069196 http://dx.doi.org/10.5114/kitp.2018.76481 Text en Copyright: © 2018 Polish Society of Cardiothoracic Surgeons (Polskie Towarzystwo KardioTorakochirurgów) and the editors of the Polish Journal of Cardio-Thoracic Surgery (Kardiochirurgia i Torakochirurgia Polska) http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Short Communication Litwinowicz, Radoslaw Witowski, Jan Sitkowski, Mateusz Filip, Grzegorz Bochenek, Maciej Michalski, Michal Banaszkiewicz, Krzysztof Urbanczyk-Zawadzka, Malgorzata Banys, Robert Sobczynski, Robert Kapelak, Boguslaw Bartus, Krzysztof Applications of low-cost 3D printing in left atrial appendage closure using epicardial approaches – initial clinical experience |
title | Applications of low-cost 3D printing in left atrial appendage closure using epicardial approaches – initial clinical experience |
title_full | Applications of low-cost 3D printing in left atrial appendage closure using epicardial approaches – initial clinical experience |
title_fullStr | Applications of low-cost 3D printing in left atrial appendage closure using epicardial approaches – initial clinical experience |
title_full_unstemmed | Applications of low-cost 3D printing in left atrial appendage closure using epicardial approaches – initial clinical experience |
title_short | Applications of low-cost 3D printing in left atrial appendage closure using epicardial approaches – initial clinical experience |
title_sort | applications of low-cost 3d printing in left atrial appendage closure using epicardial approaches – initial clinical experience |
topic | Short Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066675/ https://www.ncbi.nlm.nih.gov/pubmed/30069196 http://dx.doi.org/10.5114/kitp.2018.76481 |
work_keys_str_mv | AT litwinowiczradoslaw applicationsoflowcost3dprintinginleftatrialappendageclosureusingepicardialapproachesinitialclinicalexperience AT witowskijan applicationsoflowcost3dprintinginleftatrialappendageclosureusingepicardialapproachesinitialclinicalexperience AT sitkowskimateusz applicationsoflowcost3dprintinginleftatrialappendageclosureusingepicardialapproachesinitialclinicalexperience AT filipgrzegorz applicationsoflowcost3dprintinginleftatrialappendageclosureusingepicardialapproachesinitialclinicalexperience AT bochenekmaciej applicationsoflowcost3dprintinginleftatrialappendageclosureusingepicardialapproachesinitialclinicalexperience AT michalskimichal applicationsoflowcost3dprintinginleftatrialappendageclosureusingepicardialapproachesinitialclinicalexperience AT banaszkiewiczkrzysztof applicationsoflowcost3dprintinginleftatrialappendageclosureusingepicardialapproachesinitialclinicalexperience AT urbanczykzawadzkamalgorzata applicationsoflowcost3dprintinginleftatrialappendageclosureusingepicardialapproachesinitialclinicalexperience AT banysrobert applicationsoflowcost3dprintinginleftatrialappendageclosureusingepicardialapproachesinitialclinicalexperience AT sobczynskirobert applicationsoflowcost3dprintinginleftatrialappendageclosureusingepicardialapproachesinitialclinicalexperience AT kapelakboguslaw applicationsoflowcost3dprintinginleftatrialappendageclosureusingepicardialapproachesinitialclinicalexperience AT bartuskrzysztof applicationsoflowcost3dprintinginleftatrialappendageclosureusingepicardialapproachesinitialclinicalexperience |