Title

Application of 3-Dimensional Computed Tomographic Image Guidance to WATCHMAN Implantation and Impact on Early Operator Learning Curve: Single-Center Experience

Document Type

Article

Publication Date

11-28-2016

Publication Title

JACC Cardiovasc Interv

Abstract

OBJECTIVES: The aim of this study was to examine the impact of 3-dimensional (3D) computed tomographic (CT) guided procedural planning for left atrial appendage (LAA) occlusion on the early operator WATCHMAN learning curve.

BACKGROUND: Traditional WATCHMAN implantation is dependent on 2-dimensional transesophageal echocardiographic (TEE) sizing and intraprocedural guidance.

METHODS: LAA occlusion with the WATCHMAN device was performed in 53 patients. Pre-procedural case plans were generated from CT studies with recommended device size, catheter selection, and C-arm angle for deployment.

RESULTS: All 53 patients underwent successful LAA occlusion with the WATCHMAN. Three-dimensional CT LAA maximal-width sizing was 2.7 ± 2.2 mm and 2.3 ± 3.0 mm larger than 2-dimensional and 3D TEE measurements, respectively (p ≤ 0.0001). By CT imaging, device selection was 100% accurate. There were 4 peri-WATCHMAN leaks (

CONCLUSIONS: Three-dimensional CT image case planning provides a comprehensive and customized patient-specific LAA assessment that appears to be accurate and may possibly facilitate reducing the early WATCHMAN implantation learning curve.

Medical Subject Headings

Aged; Aged, 80 and over; Anatomic Landmarks; Atrial Appendage; Cardiac Catheterization; Clinical Competence; Echocardiography, Three-Dimensional; Echocardiography, Transesophageal; Female; Humans; Imaging, Three-Dimensional; Learning Curve; Male; Michigan; Predictive Value of Tests; Prosthesis Design; Radiographic Image Interpretation, Computer-Assisted; Reproducibility of Results; Septal Occluder Device; Therapy, Computer-Assisted; Tomography, X-Ray Computed; Treatment Outcome

PubMed ID

27884358

Volume

9

Issue

22

First Page

2329

Last Page

2340

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