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VIDAA: Virtual platform for Device Implantation in the Left Atrial Appendage

VIDAA: Virtual platform for Device Implantation in the Left Atrial Appendage

Structural heart disease refers to a defect in the heart valves, walls, or chambers, leading to more than 8000/year complex cardiac procedures in Spain. The left atrial appendage occlusion (LAAO) represents 13% of structural heart procedures (SHP), emerging as an effective treatment option for patients with non-valvular atrial fibrillation (AF).

One way to reduce the risk of thrombus in patients with AF is through anticoagulants, but many of them have contraindications, making LAAO an interesting alternative treatment. LAAOs are complex procedures where the physician makes key different decisions for each patient (e.g., type of device, size, position) due to the high left atrium (LA) variability.

Therefore, the LAAO success excessively depends on the physician's expertise; incorrect decisions may lead to complications during and after the procedure, some affecting up to 16% of patients. Nowadays, LAAO interventions are planned mainly by exploring medical images with basic and black-box computational tools without user interaction, providing limited information on blood flow patterns. During the last years at UPF, we have developed the VIDAA platform, a 3D web-based interactive tool developed to allow clinicians or an engineer from a medical device company to interactively select the most appropriate LAAO configuration (type of device, size, and positioning) for a given patient-specific LA morphology. The project's main objective is to introduce the VIDAA platform as a service in the clinical market to select the optimal setting before LAAO and predict adverse events after device implantation. It is also considered to be a device design optimization tool that allows companies to improve their devices so that they can test them beforehand in virtual hearts.

The project includes extending the service to other use cases of SHP. VIDAA is beneficial for the reduction of costs related to the use of more than one device for each intervention; the learning curve required for a new device to be used with excellent outcomes; the virtual demonstration of advantages of new device designs; and having faster interventions due to a better pre-planning. Patients will subsequently benefit from more personalised and optimised interventions, with clinical decisions more independent of the physician's experience.