3D printing for left atrial appendage closure: A meta-analysis and systematic review

Int J Cardiol. 2022 Jun 1:356:38-43. doi: 10.1016/j.ijcard.2022.03.042. Epub 2022 Mar 28.

Abstract

Background: Three-dimensional printing (3D) has emerged as an alternative to imaging to guide left atrial appendage closure (LAAC) device sizing.

Aims: We assessed the usefulness of 3D printing compared to a standard imaging-only approach for LAAC.

Methods: We identified studies comparing an imaging-only with a 3D printing approach in LAAC. A fixed-effects meta-analysis was performed targeting a co-primary endpoint of disagreement in device sizing and leaks.

Results: Eight studies that assigned 283 participants to an imaging-only approach and 3D printing approach (145 patients) were included. 3D printing significantly reduced the risk of the co-primary endpoint (risk raio (RR) = 0.19; 95% confidence interval (CI) 0.09-0.37), with consistency across the studies (I2 = 0%). Individually, both device size disagreements [RR 0.13 (95% CI 0.06-0.29), P < 0.001] and leaks [RR 0.24 (95% CI 0.09-0.64) P = 0.004] were reduced under a 3D printing modeling strategy.

Conclusion: Compared with an imaging-only strategy, 3D printing is associated with reduction in device size disagreements and leaks.

Keywords: 3D printing; Left atrial appendage closure; Peridevice leaks.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Atrial Appendage* / diagnostic imaging
  • Atrial Appendage* / surgery
  • Atrial Fibrillation* / diagnostic imaging
  • Atrial Fibrillation* / surgery
  • Cardiac Catheterization
  • Cardiac Surgical Procedures* / methods
  • Echocardiography, Transesophageal / methods
  • Humans
  • Printing, Three-Dimensional
  • Treatment Outcome