Utility of 3D printing of left atrial appendages for closure with Watchman Devices and comparison of computed tomography and transesophageal echocardiography based models

Mohammed M. Ansari MD, Ali Akbar Arvandi MD, Ronnie Orozco MS, CCR, Carlos Morales MD, Kate M. Serralde C-CM, Bernardo Galvan BS, Ozman Ochoa BS MS, Katherine G. Holder BBA, Marina Iskandir MD, Scott Shurmur MD

ABSTRACT

Three-dimensional (3D) printed cardiac models are useful for WATCHMAN device procedural planning, sizing, and complication reduction. These models also provide accurate representation of dynamic heart anatomy, helping practitioners determine their procedural approach and select proper device sizing. While the advantages of 3D models obtained from computed tomography (CT) and transesophageal echocardiography (TEE) over 2D TEE imaging for WATCHMAN procedural planning has been demonstrated, this project aims to directly compare 3D CT models and 3D TEE models to determine which model provides more useful information. We used CT and TEE 2D imaging studies from patients who underwent left atrial appendage (LAA) WATCHMAN closure device implantation as templates for 3D cardiac models. These 3D models were scored using a 10-point Likert questionnaire by a diverse team that included cardiologists, research specialists, medical students, and 3D printing technicians. Three-dimensional models developed from CT scans demonstrated better value than TEE 3D models by all qualitative measures. Scoring indicates that CT based 3D models are superior tools for WATCHMAN sizing, multilevel medical education, and physician preparation. To our knowledge, this is the only study that compares 3D models crafted from each imaging modality, and we suggest that future use of 3D modeling techniques should be based on CT scans.

Keywords: cardiac three-dimensional models, three-dimensional printing, left atrial appendage occlusion, computed tomography, transesophageal electrocardiogram, WATCHMAN Closure Device, medical education

Article citation: Ansari MM, Arvandi AA, Orozco R, Morales C, Serralde KM, Galvan B, Ochoa O, Holder KG, Iskandir M, Shurmur S. Utility of 3D printing of left atrial appendages for closure with Watchman Devices and comparison of computed tomography and transesophageal echocardiography based models. The Southwest Respiratory and Critical Care Chronicles 2021;9(37):60–65
From: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
Submitted: 12/17/2020
Accepted: 1/12/2021
Reviewer: Ankush Lahoti MD, Pooja Sethi MD
Conflicts of interest: none
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