Is pre-procedural CT TruPlan-based reasonably enough?
The authors have performed LAAO by using ICE to guide transseptal
puncture and view the LAA from the left atrium. The use of ICE favors a
smoother intraprocedural workflow, since general anesthesia is not
required and the operator can easily maneuver the ICE probe with no need
of the echo expert’s assistance. In our own experience, LAA
visualization and measurements, ruling out thrombus, device sizing and
placement can effectively achieved through ICE and with an excellent
outcome (9). Also, with the advent of 3-D ICE technology (10), more
reliable and adequate measurements is offered guiding to a successful
and safe LAAO procedure . Unfortunately, in this prospective study there
is no data comparing the pre-procedural CT information obtained through
the TruPlan software with that produced by intraprocedural ICE. The
demonstration that device selection provided by pre-procedural CT-scan
TruPlan software based consistently coincides with the device sizing
obtained by intraprocedural ICE measurements, would have reinforced the
significance of this novel pre-procedural CT methodology. Furthermore,
no direct comparison was made in randomizing fashion with other CT-scan
sizing methodologies.