TCTAP A-080 Patient-specific Cardiovascular Models for Educational and Training Purposes

ObjectivesThis retrospective study compared two mandibular reconstruction procedures—conventional reconstruction plates (CR) and patient-specific implants (PSI)—and evaluated their accuracy of reconstruction and clinical outcome.MethodsOverall, 94 patients had undergone mandibular reconstruction with CR (n = 48) and PSI (n = 46). Six detectable and replicable anatomical reference points, identified via computer tomography, were used for defining the mandibular dimensions. The accuracy of reconstruction was assessed using pre- and postoperative differences.ResultsIn the CR group, the largest difference was at the lateral point of the condyle mandibulae (D2) -1.56 mm (SD = 3.8). In the PSI group, the largest difference between preoperative and postoperative measurement was shown at the processus coronoid (D5) with +1.86 mm (SD = 6.0). Significant differences within the groups in pre- and postoperative measurements were identified at the gonion (D6) [t(56) = -2.217; p = .031 <.05]. In the CR group, the difference was 1.5 (SD = 3.9) and in the PSI group -1.04 (SD = 4.9). CR did not demonstrate a higher risk of plate fractures and post-operative complications compared to PSI.ConclusionFor reconstructing mandibular defects, CR and PSI are eligible. In each case, the advantages and disadvantages of these approaches must be assessed. The functional and esthetic outcome of mandibular reconstruction significantly improves with the experience of the surgeon in conducting microvascular grafts and familiarity with computer-assisted surgery. Interoperator variability can be reduced, and training of younger surgeons involved in planning can be reaching better outcomes in the future.

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Digital Design and 3D Printing of Aortic Arch Reconstruction in HLHS for Surgical Simulation and Training

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135118771323 ◽

2018 ◽

Vol 9 (4) ◽

pp. 454-458 ◽

Cited By ~ 8

Author(s):

Sarah A. Chen ◽

Chin Siang Ong ◽

Nagina Malguria ◽

Luca A. Vricella ◽

Juan R. Garcia ◽

...

Keyword(s):

3D Printing ◽

Aortic Arch ◽

Surgical Simulation ◽

Three Dimensional ◽

3D Models ◽

Digital Design ◽

Patient Specific ◽

Aortic Arch Reconstruction ◽

Arch Reconstruction ◽

And Training

Purpose: Patients with hypoplastic left heart syndrome (HLHS) present a diverse spectrum of aortic arch morphology. Suboptimal geometry of the reconstructed aortic arch may result from inappropriate size and shape of an implanted patch and may be associated with poor outcomes. Meanwhile, advances in diagnostic imaging, computer-aided design, and three-dimensional (3D) printing technology have enabled the creation of 3D models. The purpose of this study is to create a surgical simulation and training model for aortic arch reconstruction. Description: Specialized segmentation software was used to isolate aortic arch anatomy from HLHS computed tomography scan images to create digital 3D models. Three-dimensional modeling software was used to modify the exported segmented models and digitally design printable customized patches that were optimally sized for arch reconstruction. Evaluation: Life-sized models of HLHS aortic arch anatomy and a digitally derived customized patch were 3D printed to allow simulation of surgical suturing and reconstruction. The patient-specific customized patch was successfully used for surgical simulation. Conclusions: Feasibility of digital design and 3D printing of patient-specific patches for aortic arch reconstruction has been demonstrated. The technology facilitates surgical simulation. Surgical training that leads to an understanding of optimal aortic patch geometry is one element that may potentially influence outcomes for patients with HLHS.

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Patient specific 3D surfaces for interactive medical planning and training

Proceedings of the 20th International Conference on 3D Web Technology - Web3D '15 ◽

10.1145/2775292.2775294 ◽

2015 ◽

Cited By ~ 3

Author(s):

Felix G. Hamza-Lup ◽

Shane Farrar ◽

Erik Leon

Keyword(s):

Patient Specific ◽

Medical Planning ◽

And Training ◽

3D Surfaces

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Tuning a Multiscale Model of Abdominal Aortic Hemodynamics to Incorporate Patient-Specific Features of Flow and Pressure Waveforms

ASME 2009 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2009-206179 ◽

2009 ◽

Author(s):

Ryan L. Spilker ◽

Charles A. Taylor

Keyword(s):

Boundary Conditions ◽

Computational Models ◽

Multiscale Model ◽

Patient Specific ◽

Vascular Walls ◽

Outflow Boundary Conditions ◽

Abdominal Aortic ◽

Cardiovascular Models ◽

Outflow Boundary ◽

Aortic Hemodynamics

Computational models enable the calculation of quantities that are impractical or impossible to measure and the prediction of physiological changes due to interventions. In order to be useful, cardiovascular models must be both rooted in physical principles and designed such that measured or otherwise desired features of the cardiovascular system are reproduced. The former requirement has motivated the development of image-based anatomic models, patient-specific inflow boundary conditions, deformable vascular walls, outflow boundary conditions that represent the influence of the downstream circulation, and multiscale models. The development of approaches to address the latter requirement, reproducing desired features of the circulation, is a critical area of modeling research that has received comparatively little attention.

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Development of a patient-specific atrial phantom model for planning and training of inter-atrial interventions

Medical Physics ◽

10.1002/mp.12559 ◽

2017 ◽

Vol 44 (11) ◽

pp. 5638-5649 ◽

Cited By ~ 8

Author(s):

Pedro Morais ◽

João Manuel R. S. Tavares ◽

Sandro Queirós ◽

Fernando Veloso ◽

Jan D'hooge ◽

...

Keyword(s):

Patient Specific ◽

Phantom Model ◽

And Training

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Towards an interactive electromechanical model of the heart

Interface Focus ◽

10.1098/rsfs.2012.0091 ◽

2013 ◽

Vol 3 (2) ◽

pp. 20120091 ◽

Cited By ~ 18

Author(s):

Hugo Talbot ◽

Stéphanie Marchesseau ◽

Christian Duriez ◽

Maxime Sermesant ◽

Stéphane Cotin ◽

...

Keyword(s):

Cardiac Electrophysiology ◽

Graphics Processing Unit ◽

Cardiac Resynchronization ◽

Patient Specific ◽

Processing Unit ◽

Resynchronization Therapy ◽

Specific Data ◽

Electrophysiological Signals ◽

Graphics Processing ◽

And Training

In this work, we develop an interactive framework for rehearsal of and training in cardiac catheter ablation, and for planning cardiac resynchronization therapy. To this end, an interactive and real-time electrophysiology model of the heart is developed to fit patient-specific data. The proposed interactive framework relies on two main contributions. First, an efficient implementation of cardiac electrophysiology is proposed, using the latest graphics processing unit computing techniques. Second, a mechanical simulation is then coupled to the electrophysiological signals to produce realistic motion of the heart. We demonstrate that pathological mechanical and electrophysiological behaviour can be simulated.

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Development of Patient Specific Cardiovascular Models Predicting Dynamics in Response to Orthostatic Stress Challenges

Lecture Notes in Mathematics - Mathematical Modeling and Validation in Physiology ◽

10.1007/978-3-642-32882-4_10 ◽

2012 ◽

pp. 177-213 ◽

Cited By ~ 2

Author(s):

Johnny T. Ottesen ◽

Vera Novak ◽

Mette S. Olufsen

Keyword(s):

Patient Specific ◽

Orthostatic Stress ◽

Cardiovascular Models

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Requirements for the formal representation of pathophysiology mechanisms by clinicians

Interface Focus ◽

10.1098/rsfs.2015.0099 ◽

2016 ◽

Vol 6 (2) ◽

pp. 20150099 ◽

Cited By ~ 3

Author(s):

B. de Bono ◽

M. Helvensteijn ◽

N. Kokash ◽

I. Martorelli ◽

D. Sarwar ◽

...

Keyword(s):

Quantitative Methods ◽

Clinical Decision Making ◽

Clinical Decision ◽

Patient Specific ◽

Formal Representation ◽

Disease Mechanism ◽

Clinical Community ◽

Specific Behaviour ◽

And Training ◽

Representation Of Knowledge

Knowledge of multiscale mechanisms in pathophysiology is the bedrock of clinical practice. If quantitative methods, predicting patient-specific behaviour of these pathophysiology mechanisms, are to be brought to bear on clinical decision-making, the Human Physiome community and Clinical community must share a common computational blueprint for pathophysiology mechanisms. A number of obstacles stand in the way of this sharing—not least the technical and operational challenges that must be overcome to ensure that (i) the explicit biological meanings of the Physiome's quantitative methods to represent mechanisms are open to articulation, verification and study by clinicians, and that (ii) clinicians are given the tools and training to explicitly express disease manifestations in direct contribution to modelling. To this end, the Physiome and Clinical communities must co-develop a common computational toolkit, based on this blueprint, to bridge the representation of knowledge of pathophysiology mechanisms (a) that is implicitly depicted in electronic health records and the literature, with (b) that found in mathematical models explicitly describing mechanisms. In particular, this paper makes use of a step-wise description of a specific disease mechanism as a means to elicit the requirements of representing pathophysiological meaning explicitly. The computational blueprint developed from these requirements addresses the Clinical community goals to (i) organize and manage healthcare resources in terms of relevant disease-related knowledge of mechanisms and (ii) train the next generation of physicians in the application of quantitative methods relevant to their research and practice.

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Cysto-Vaginoscopy of a 3D-Printed Cloaca Model: A Step toward Personalized Noninvasive Preoperative Assessment in Patients with Complex Anorectal Malformations

European Journal of Pediatric Surgery ◽

10.1055/s-0041-1726424 ◽

2021 ◽

Author(s):

Wilfried Krois ◽

Lukas Schmölz ◽

Michael Wagner ◽

Peter Gröpel ◽

Ewald Unger ◽

...

Keyword(s):

Preoperative Planning ◽

Real Life ◽

Anorectal Malformations ◽

Patient Specific ◽

Training Tool ◽

Cloacal Malformation ◽

Preoperative Training ◽

Real Size ◽

3D Printed ◽

And Training

Abstract Introduction For the classification of the complexity of cloacal malformations and the decision on the operative approach, an exact anatomical assessment is mandatory. To benefit from using three-dimensional (3D)-printed models in preoperative planning and training, the practicability of these models should be guaranteed. The aim of this study was to evaluate the quality and feasibility of a real-size 3D-printed cloaca model for the purpose of cysto-vaginoscopic evaluation. Materials and Methods We performed a 3D reconstruction and printed a real-size, rubber-like 3D model of an infant pelvis with a cloacal malformation and asked invited pediatric surgeons and pediatric urologists to perform a cysto-vaginoscopy on the model and to complete a brief questionnaire to rate the quality and feasibility of the model and to indicate whether they would recommend the model for preoperative planning and training. Results Overall, 41 participants rated the model quality as good to very good (M = 3.28, standard deviation [SD] = 0.50, on a scale from 1 to 4). The model was rated as feasible for preoperative training (M = 4.10, SD = 0.75, on a scale from 1 to 5) and most participants (85.4%) would recommend the model for preoperative training. The cysto-vaginoscopy of the model was considered as a valid training tool for real-life cases and improved the confidence on the anatomy of a cloaca. Conclusion The results of our study indicate that patient-specific 3D-printed models might be a useful tool in the preoperative evaluation of complex anorectal malformations by simulation of cysto-vaginoscopy with an excellent view on anatomical structures to assess the whole spectrum of the individual cloacal malformation. Our model might be a valuable add-on tool for specialty training in pediatric colorectal surgery.

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