Affiliation:
1. Department of Cardiology, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, #1665 Kong Jiang Road, Shanghai 200092, China
Abstract
Abstract
Aims
We evaluated the feasibility of left atrial appendage (LAA) closure guided by the image fusion of integrating fluoroscopy into 3D computed tomography (CT).
Methods and results
A total of 117 consecutive patients who underwent LAA closure with or without the image fusion were matched (1:2). Each LAA closure step of the Image fusion group was guided by the preprocedure CT and image fusion, especially in the plan of LAA measurement and transseptal puncture. All patients were successfully implanted with a WATCHMAN closure device. Comparing the two groups, the mean number of recapture times and the number of devices per patient of the Image fusion group were significantly lower (0.4 ± 0.5 vs. 0.7 ± 0.8, P = 0.031 and 1.0 ± 0.2 vs. 1.1 ± 0.3, P = 0.027, respectively). The one-time successful deployment rate by the support of the image fusion was higher than in the control group (66.7% vs. 44.9%, P = 0.026). Each case of the Image fusion group was completely occluded with one transseptal puncture, while five of the Non-image fusion group required redo transseptal punctures. During the 45-day follow-up, both group cases presented occlusion efficiency and no major adverse cardiac events were observed.
Conclusion
Image fusion technique integrating fluoroscopy into the 3D CT is safe and feasible which can be easily incorporated into the procedural work-flow of percutaneous LAA closure. The fusion image can play an important alternative role in the plan of LAA measurement and transseptal puncture site for improving the LAA closure procedure.
Funder
National Natural Science Foundation of China
State Key Program of National Natural Science Foundation of China
Shanghai Science and Technology Committee Clinical Field Project
Basic Science Foundation of Xinhua Hospital Affiliated with the School of Medicine, the Shanghai Jiaotong University
Medical-Engineering Cross Foundation of Shanghai Jiaotong University
Publisher
Oxford University Press (OUP)
Subject
Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging,General Medicine
Cited by
24 articles.
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