{"id":"bcba630de750","type":"article","url":"https://hartvaat.nl/2026/08/15/3d-ct-fluoroscopie-fusie-maakt-laac-efficienter-minder-contrast-minder-straling-/","title":"3D CT-fluoroscopie-fusie maakt LAAC efficiënter: minder contrast, minder straling, korte procedure","title_en":"","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"International journal of cardiology","doi":"10.1016/j.ijcard.2026.134536","source_url":"https://doi.org/10.1016/j.ijcard.2026.134536","authors":["Xiancun Yang","Youwei Sun","Nan Zhang","Jianle Xu","Baocheng Geng","Ying Wang"],"significance":5,"published":"2026-07-01","source_date":"2026-08-15","image":"","kennis":[],"congress":"","summary_en":"Retrospective comparative study of 109 consecutive patients undergoing left atrial appendage closure (LAAC) using 3D CT-fluoroscopy fusion (n=51) versus the Real-time Operation Guidance Planning System (ROGPS, n=58). The fusion group required significantly less contrast (60.2 vs 75.3 mL; p<0.001), shorter fluoroscopy time (8.0 vs 10.2 min; p=0.002), and shorter total procedure time (62.2 vs 68.5 min; p=0.005). Radiation dose (DAP) was also lower (29.8 vs 42.2 Gy·cm²; p=0.01). Procedural success was 100% in both groups. Device-related thrombosis and peridevice leak did not differ significantly. 3D CT-fluoroscopy fusion thus improves LAAC efficiency without compromising safety.","created":"2026-07-03T10:33:09Z","updated":"2026-07-03T13:32:03Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Retrospectieve vergelijkende studie van 109 opeenvolgende patiënten die linker-hartoor-occlusie (LAAC) ondergingen met 3D CT-fluoroscopie-fusie (n=51) versus het Real-time Operation Guidance Planning System (ROGPS, n=58). De fusiegroep had significant minder contrast (60,2 vs 75,3 mL; p<0,001), kortere fluoroscopietijd (8,0 vs 10,2 min; p=0,002) en kortere totale procedureduur (62,2 vs 68,5 min; p=0,005). Stralingsdosis (DAP) was eveneens lager (29,8 vs 42,2 Gy·cm²; p=0,01). Procedureel succes was 100% in beide groepen. Device-related thrombosis en peri-device leak verschilden niet significant. 3D CT-fluoroscopie-fusie verbetert dus de efficiëntie van LAAC zonder de veiligheid te compromitteren.","abstract_original":"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."}