Abstract 21241: One Device Closure for Multiple Atrial Septal Defects Guided With Thoracic Echocardiography: The Role of Personalized Three-Dimensional Printing

Abstract

Introduction: Single device closure for multiple atrial septal defects (ASD) is still challenging due to the complicated anatomy and technical difficulty. The emerging three-dimensional (3D) printing facilitates the identification anatomical structure, helps the procedural planning and simplifies the imaging monitoring for the transcatheter closure. Hypothesis: We therefore aimed to testify the possibility of single device for multiple ASDs under the guidance of transthoracic echocardiography with the aid of 3D printing models in this prospective study. Methods: Stereolithography data was acquired with cardiac CT scan in 30 patients (20±16 years, 18 females) having multiple ASDs and personal 1:1 scale 3D printed model was printed. Closure planning, including determination of target defect, occluder selection and device placement, was attempted on the model before intervention. Transcatheter closure was performed under the guidance of transthoracic echocardiography. The conventional selection of device was compare to the method based on 3D models. The clinical effect was assessed immediately after device closure and at 3-month follow-up. Results: 3D printing model was successfully established in all patients and 26 cases were suitable for transcatheter closure according to model test. Transcatheter closure with single device was completed in 26 patients (including 14 patients with defect distance >7mm) even under the guidance of the transthoracic echocardiography without complications.Compared to conventional method, device selection was more accurate in 3D model. Immediate postoperative echocardiography demonstrated mild residual shunt in 5 patients whereas disappeared in 3 patients and decreased in the other 2 patients at 3-month follow-up. Conclusions: 3D printing technology and echocardiography guiding procedure enables single device for closure of multiple ASDs including challenge cases.