title: [Application of Mimics three-dimensional imaging in percutaneous left atrial appendage closure with Watchman system].
abstract: OBJECTIVE
  The three-dimensional (3D) structure of left atrial appendage (LAA) in atrial fibrillation patients were reconstructed by Mimics 3D imaging system, aiming at guiding for selection of both the size and location of the closure devices and making preliminary risk assessment of LAA closure with Watchman system.
  
  
  METHODS
  Inclusion criteria were: ten voluntary patients with both atrial fibrillation and indication for LAA closure aging from 40 to 85 years old with contraindication for oral anticoagulants or unwillingness to take long-term oral anticoagulation therapy from May to December 2014. 3D reconstruction of LAA was preoperatively made by Mimics 3D imaging system. With the Mimics 3D reconstruction model and the results of both transesophageal echocardiography (TEE) and LAA radiography, the size and location for the closure device were chosen. The devices were planted at the ostium of the LAA.
  
  
  RESULTS
  Ten atrial fibrillation patients were enrolled (average age: (66.3±11.9) years old) and all successfully implanted with the Watchman LAA closure devices. Nine of them were with non-valvular atrial fibrillation with average CHADS2-VAS score (3.2±1.7) and HAS-BLED score (2.7±1.6). The rest one was a valvular atrial fibrillation patient with the history of the percutaneous balloon mitral valvuloplasty (PBMV) without surgical indications of mitral valve replacement (MVR). There was no blood leakage around the device by regular postoperative TEE and LAA radiography examinations. There were no complications of bleeding, embolism, or stroke through both at peri-operative period and at 1 month follow-up post procedure.
  
  
  CONCLUSIONS
  Preoperative Mimics 3D reconstruction of LAA by Mimics 3D imaging system among atrial fibrillation patients provides essential information guiding the successful LAA closures.
authors.affiliation: Department of Cardiovascular Diseases of the Affiliated Hospital of Hangzhou Normal University, Hangzhou 310000, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Yang
authors.forename: Zhao
authors.initials: Z
authors.lastname: Xu
authors.forename: Yiqun
authors.initials: Y
authors.lastname: Zhang
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Luo
authors.forename: Juhong
authors.initials: J
authors.lastname: Zhang
authors.forename: Yigang
authors.initials: Y
authors.lastname: Wang
authors.forename: Brendan
authors.initials: B
authors.lastname: Gunalingam
authors.affiliation: Email: hsdzxw@126.com.
authors.forename: Xingwei
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants; D020517:Atrial Appendage / Q000601:surgery*; D001281:Atrial Fibrillation / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D000075202:Contraindications; D017548:Echocardiography, Transesophageal; D004617:Embolism; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D020521:Stroke; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants