Successful Catheter Treatment Using Pre-Operative 3D Organ Model Simulation for Atrial Septal Defect With Dextrocardia and Interrupted Inferior Vena Cava to?the?Superior Vena Cava
Successful Catheter Treatment Using Pre-Operative 3D Organ Model Simulation for Atrial Septal Defect With Dextrocardia and Interrupted Inferior Vena Cava to?the?Superior Vena Cava
复制标题
使用术前 3D 器官模型模拟成功导管治疗右心房间隔缺损和下腔静脉至上腔静脉中断
DOI：
10.1016/j.jcin.2018.01.243
复制
发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Kimura Takeshi
中科院分区：
文献类型：
--
作者：
Imai Masao;Yoshida Masaharu;Toyota Toshiaki;Shiomi Hiroki;Shizuta Satoshi;Saito Naritatsu;Kimura Takeshi
1例31岁男性患者，有内翻、右位心、下腔静脉中断并奇静脉延续的病史(图1A)。经食道超声心动图显示房间隔缺损(ASD)9 mm×16 mm，连续左右分流，主动脉缘小，原间隔和继发间隔缺损面不同，显示排列不齐(图1B)。为了对具有如此复杂解剖结构的患者进行导管介入治疗，使用三维(3D)器官模型(日本京都Cross Effect Inc.)通过CT成像构建了术前模拟(图1C)。根据术前经食道超声心动图和CT所显示的缺损大小选择了21 mm的Occlutech ASD封堵器Figulla Flex2(Occlutech GmbH，德国耶拿)。为了进行导管介入治疗，我们使用了12-F FlexCath高级可控鞘经左颈静脉途径进行冷冻消融(美敦力，明尼阿波利斯，明尼苏达州)。随后，在弹性橡胶模型中成功地进行了体外试验封堵，用于术前评估(图1D和1E)。在实际的临床过程中，该装置部署成功。术后CT检查
A31-year-old male patient with a history of situs inversus, dextrocardia, and interrupted inferior vena cava (IVC) with azygous continuation referred to our hospital (Figure 1A). Transesophageal echocardiography revealed a 9 mm x 16 mm atrial septal defect (ASD) with continuous left-toright shunting with small aortic rim and the defect surface of the septum primum is different from that of the septum secundum, which indicates malalignment (Figure 1B). To perform catheter intervention for a patient with such a complicated anatomy, pre-operative simulation using a 3-dimensional (3D) organ model (Cross Effect Inc., Kyoto, Japan) was constructed by computed tomography (CT) imaging (Figure 1C). A 21-mm Occlutech ASD Occluder Figulla Flex2 (Occlutech GmbH, Jena, Germany) was selected in accordance with the defect size as seen on pre-procedural transesophageal echocardiography and CT.To perform this catheter intervention, we used a 12-F FlexCath Advance Steerable Sheath for cryoablation (Medtronic, Minneapolis, Minnesota) via a left jugular venous approach. Subsequently, an in vitro trial occlusion was performed successfully in the elastic rubber model for pre-operative evaluation (Figures 1D and 1E). In the real clinical procedure, the device was deployed successfully. Post-operative CT