Percutaneous Closure of Left Ventricular Outflow Tract to Left Atrium Fistula With 3-Dimensional Printing Simulation

We present a case of a 31-year-old man with a history of aortic valve endocarditis and surgical aortic intervention. Computed tomography revealed a complex serpiginous fistula with 2 openings between the left ventricular outflow tract and the left atrium. Using 3-dimensional printing simulation for device fit testing and planning, the "mother-in-daughter" system, multimodality guidance with computed tomography angiography C-arm prediction, and 3-dimensional transesophageal echocardiogram guidance successfully guided an 18-mm Cribriform Amplatzer device deployed via a retrograde approach. Three-dimensional printing simulation significantly enhances preprocedural planning and device selection for this complex fistula closure, facilitating successful percutaneous repairs in high-risk patients.