A Three Dimensional Simulation System for Determining the Optimal Size of Amplatzer Septal Occluder before the Procedure of Transcatheter Occlusion of Atrial Septal Defect: A pilot feasibility study

  • Dr Kun Sun, Department of Pediatric Cardiology, Shanghai Children’s Medical Center, China
  • Dr WenJing Hong, Department of Pediatric Cardiology, Shanghai Children’s Medical Center, Shanghai Jiaotong University, China
  • Prof JianGuo Yu, School of computer science, Shanghai Fudan University, China
  • Ms Nan Zhao, School of computer science, Shanghai Fudan University, China
  • Ms LanPing Wu, Department of Pediatric Cardiology, Shanghai Children’s Medical Center, Shanghai Jiaotong University, China

    • Objective
    To evaluate the feasibility of our self-designed three dimensional simulation system (3DSS)for determining the optimal size of Amplatzer septal occluder before the procedure of transcatheter occlusion of atrial septal defect(ASD).
    Methods
    3D volume rendering and 3D visualization methods were used for the development of 3DSS. 30 children (9 male and 21femal, aged 6.37±3.49 years) with ASD who have been successfully underwent transcatheter occlusion were recruited in this study. 3D modeling method was used for simulating the shape and the size of each occlusion device. The simulated devise was “deployed” into ASD, which was reconstructed from 3DE data set of each patient before ASO occlusion, with the axes of the devise at the center of the decussation of the major and minor axis of ASD. The size of right disk and left disk of the simulated device and the distance between the inferior margin of device and mitral and tricuspid valve of simulation occluder were measured using 3DSS, and the results were compared with that measured from the 3D imaging of the same patient one day after successfully underwent transcatheter closure of ASD using Tomtec 3DE system.
    Results
    No significant difference between simulation occluder and ASO in size and the distance between the inferior margin of device and mitral and tricuspid valve measured by 3DSS and by the Tomtec 3DE system one day after successful occlusion (P>0.05).
    Conclusions
    The 3DSS could be a usefull noninvasive method for ASO selection before the procedure of transcatheter occlusion of ASD.