Virtual reality utilization for left atrial appendage occluder device size prediction
Shai Tejman-Yarden,
Dor Freidin,
Netanel Nagar,
Yisrael Parmet,
Muhamed Abed,
Oliana Vazhgovsky,
David Yogev,
Dov Ganchrow,
Efrat Mazor-Drey,
Sumit Chatterji,
Roy Beinart,
Israel Barbash,
Victor Guetta,
Orly Goitein
Affiliations
Shai Tejman-Yarden
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; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Corresponding author. The Edmond J. Safra International Congenital Heart Center, Sheba Medical Center, Ramat Gan, Israel.
Dor Freidin
The Engineering Medical Research Lab, Sheba Medical Center, Ramat Gan, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Netanel Nagar
The Engineering Medical Research Lab, Sheba Medical Center, Ramat Gan, Israel
Yisrael Parmet
Department of Industrial Engineering and Management, Ben Gurion University, Beer Sheva, Israel
Muhamed Abed
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; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Oliana Vazhgovsky
The Engineering Medical Research Lab, Sheba Medical Center, Ramat Gan, Israel
David Yogev
The Engineering Medical Research Lab, Sheba Medical Center, Ramat Gan, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Dov Ganchrow
Industrial Design Department, Bezalel Academy of Art and Design, Jerusalem, Israel
Efrat Mazor-Drey
The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; The Leviev Heart Institute, Sheba Medical Center, Ramat Gan, Israel
Sumit Chatterji
The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; The Pulmonology Unit, Sheba Medical Center, Ramat Gan, Israel; Interventional Pulmonology Unit, ShebaMedical Center, Ramat Gan, Israel
Roy Beinart
The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; The Leviev Heart Institute, Sheba Medical Center, Ramat Gan, Israel
Israel Barbash
The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; The Leviev Heart Institute, Sheba Medical Center, Ramat Gan, Israel
Victor Guetta
The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; The Leviev Heart Institute, Sheba Medical Center, Ramat Gan, Israel
Orly Goitein
The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel
Aim: 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. Method: 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 (ρc), the mean difference, and the mean square error (MSE). Results: 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 ρc 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 ρc 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. Discussion: 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.
