3D CT-fluoroscopie-fusie maakt LAAC efficiënter: minder contrast, minder straling, korte procedure

Real-time three-dimensional (3D) fusion of cardiac computed tomography (CT) with fluoroscopy may enhance procedural guidance in left atrial appendage closure (LAAC), yet comparative data with conventional planning systems are limited METHODS: In this retrospective comparative study, 109 consecutive patients undergoing LAAC were assigned to guidance using either 3D CT-fluoroscopy fusion (n = 51) or the real-time operation guidance planning system (ROGPS, n = 58). Procedural efficiency, radiation exposure, contrast use, and clinical outcomes were analyzed RESULTS: The 3D fusion group demonstrated significant reductions in contrast volume (60.2 ± 15.0 mL vs. 75.3 ± 15.0 mL, p < 0.001), fluoroscopy time (8.0 ± 3.6 min vs. 10.2 ± 3.7 min, p = 0.002), and total procedure time (62.2 ± 12.0 min vs. 68.5 ± 11.2 min, p = 0.005). Radiation dose (DAP) was also lower in the fusion group (29.8 ± 20.8 Gy·cm2 vs. 42.2 ± 27.7 Gy·cm2, p = 0.01). Procedural success was 100% in both groups. No statistically significant differences were observed in the rates of device-related thrombosis (DRT) or peri-device leakage (PDL) CONCLUSION: 3D CT-fluoroscopy fusion imaging significantly improves procedural efficiency in LAAC compared to ROGPS, reducing contrast use, radiation exposure, and procedure time without compromising safety.