The development of a flexible heart model for simulation-based training

2020 ◽  
Author(s):  
Jelle Man ◽  
Jos Maessen ◽  
Peyman Sardari Nia
Keyword(s):  
Ct Scan ◽  
Surgical Simulation ◽  
Computer Modelling ◽  
Patient Specific ◽  
Heart Model ◽  
Flexible Material ◽  
Thoracic Ct ◽  
Simulation Based ◽  
3D Printed ◽  
Thoracic Ct Scan

Abstract OBJECTIVES Simulation-based training has shown to be effective in training new surgical skills. The objective of this study is to develop a flexible 3-dimensional (3D)-printed heart model that can serve as a foundation for the simulation of multiple cardiovascular procedures. METHODS Using a pre-existing digital heart model, 3D transoesophageal echocardiography scans and a thoracic CT scan, a full volume new heart model was developed. The valves were removed from this model, and the internal structures were remodelled to make way for insertable patient-specific structures. Groves at the location of the coronaries were created using extrusion tools in a computer-modelling program. The heart was hollowed to create a more flexible model. A suitable material and thickness was determined using prior test prints. An aortic root and valve was built by segmenting the root from a thoracic CT scan and a valve from a transoesophageal echocardiogram. Segmentations were smoothed, small holes in the valves were filled and surrounding structures were removed to make the objects suitable for 3D printing. RESULTS A hollow 3D-printed heart model with the wall thicknesses of 1.5 mm and spaces to insert coronary arteries, valves and aortic roots in various sizes was successfully printed in flexible material. CONCLUSIONS A flexible 3D-printed model of the heart was developed onto which patient-specific cardiac structures can be attached to simulate multiple procedures. This model can be used as a platform for surgical simulation of various cardiovascular procedures.

Generic design of an anatomical heart model optimized for additive manufacturing with silicone

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hannah Riedle ◽  
Ahmed Ghazy ◽  
Anna Seufert ◽  
Vera Seitz ◽  
Bernhard Dorweiler ◽  
...  
Keyword(s):  
Surgical Simulation ◽  
Patient Specific ◽  
Heart Model ◽  
Single Model ◽  
Content Type ◽  
Anatomical Features ◽  
3D Printed ◽  
Ct Data ◽  
Silicone Model ◽  
Generic Design

Purpose The purpose of this study is the generation of a thorough generic heart model optimized for direct 3D printing with silicone elastomers. Design/methodology/approach The base of the model design is segmentation of CT data, followed by a generic adaption and a constructive enhancement. The model is 3D printed with silicone. An evaluation of the physical model gives indications about its benefits and weaknesses. Findings The results show the feasibility of a generic design while maintaining anatomical correctness and the benefit of the generic approach to quickly derive a multiplicity of healthy and pathological versions from one single model. The material properties of the silicone model are sufficient for simulation, but the results of the evaluation indicate possible improvements, as for most anatomical features, the used silicone is too hard and too stretchable. Originality/value Previous developments mostly focus on patient-specific heart models. In contrast, this study sets out to explore the possibility and benefits of a generic approach. Standardized validated models would allow comparability in surgical simulation.

Thoracic CT Scan vs PET-TC Imaging in the Diagnosis of Patients Suffering Exudative Pleural Effusions with Suspicion of Malignancy

2019 ◽  
Vol 55 (10) ◽  
pp. 546
Author(s):  
Marc Simó ◽  
Esther Pallisa ◽  
Alberto Jaúregui ◽  
Bruno Montoro ◽  
Ana Vázquez ◽  
...  
Keyword(s):  
Ct Scan ◽  
Pleural Effusions ◽  
Thoracic Ct ◽  
Thoracic Ct Scan

scholarly journals Quantitative Assessment of 3D Printed Blood Vessels Produced with J750™ Digital Anatomy™ for Suture Simulation

2022 ◽  
Author(s):  
Stefania Marconi ◽  
Valeria Mauri ◽  
Erika Negrello ◽  
Luigi Pugliese ◽  
Andrea Pietrabissa ◽  
...  
Keyword(s):  
Blood Vessels ◽  
Soft Tissues ◽  
Surgical Simulation ◽  
Patient Specific ◽  
Morphological Aspects ◽  
Pathological Conditions ◽  
Surgical Simulations ◽  
Training Of Surgeons ◽  
3D Printed ◽  
Digital Anatomy

Blood vessels anastomosis is one of the most challenging and delicate tasks to learn in many surgical specialties, especially for vascular and abdominal surgeons. Such a critical skill implies a learning curve that goes beyond technical execution. The surgeon needs to gain proficiency in adapting gestures and the amount of force expressed according to the type of tissue he/she is dealing with. In this context, surgical simulation is gaining a pivotal role in the training of surgeons, but currently available simulators can provide only standard or simplified anatomies, without the chance of presenting specific pathological conditions and rare cases. 3D printing technology, allowing the manufacturing of extremely complex geometries, find a perfect application in the production of realistic replica of patient-specific anatomies. According to available technologies and materials, morphological aspects can be easily handled, while the reproduction of tissues mechanical properties still poses major problems, especially when dealing with soft tissues. The present work focuses on blood vessels, with the aim of identifying – by means of both qualitative and quantitative tests – materials combinations able to best mimic the behavior of the biological tissue during anastomoses, by means of J750™ Digital Anatomy™ technology and commercial photopolymers from Stratasys. Puncture tests and stitch traction tests are used to quantify the performance of the various formulations. Surgical simulations involving anastomoses are performed on selected clinical cases by surgeons to validate the results. A total of 37 experimental materials were tested and 2 formulations were identified as the most promising solutions to be used for anastomoses simulation. Clinical applicative tests, specifically selected to challenge the new materials, raised additional issues on the performance of the materials to be considered for future developments.

scholarly journals Impact of emergency physician experience on decision-making in patients with suspected community-acquired pneumonia and undergoing systematic thoracic CT scan

2019 ◽  
Vol 36 (8) ◽  
pp. 485-492
Author(s):  
Josselin Le Bel ◽  
Thierry Pelaccia ◽  
Patrick Ray ◽  
Charles Mayaud ◽  
Anne-Laure Brun ◽  
...  
Keyword(s):  
Ct Scan ◽  
Emergency Physician ◽  
Patient Management ◽  
Univariate Analysis ◽  
Community Acquired Pneumonia ◽  
Emergency Physicians ◽  
Thoracic Ct ◽  
Thoracic Ct Scan ◽  
Adjudication Committee ◽  
Diagnosis Classification

ObjectivesTo determine whether the impact of a thoracic CT scan on community-acquired pneumonia (CAP) diagnosis and patient management varies according to emergency physician’s experience (≤10 vs >10 years).MethodsEarly thoracic CT Scan for Community-Acquired Pneumonia at the Emergency Department is an interventional study conducted from November 2011 to January 2013 in four French emergency departments, and included suspected patients with CAP. We analysed changes in emergency physician CAP diagnosis classification levels before and after CT scan; and their agreement with an adjudication committee. We performed univariate analysis to determine the factors associated with modifying the diagnosis classification level to be consistent with the radiologist’s CT scan interpretation.Results319 suspected patients with CAP and 136 emergency physicians (75% less experienced with ≤10 years, 25% with >10 years of experience) were included. The percentage of patients whose classification was modified to become consistent with CT scan radiologist’s interpretation was higher among less-experienced than experienced emergency physicians (54.2% vs 40.2%; p=0.02). In univariate analysis, less emergency physician experience was the only factor associated with changing a classification to be consistent with the CT scan radiologist’s interpretation (OR 1.77, 95% CI 1.01 to 3.10, p=0.04). After CT scan, the agreement between emergency physicians and adjudication committee was moderate for less-experienced emergency physicians and slight for experienced emergency physicians (k=0.457 and k=0.196, respectively). After CT scan, less-experienced emergency physicians modified patient management significantly more than experienced emergency physicians (36.1% vs 21.7%, p=0.01).ConclusionsIn clinical practice, less-experienced emergency physicians were more likely to accurately modify their CAP diagnosis and patient management based on thoracic CT scan than more experienced emergency physicians.Trial registration numberNCT01574066

Chondrosarcoma in Mafucci’s syndrome – an interdisciplinary approach to a rare disease

2012 ◽  
Vol 153 (26) ◽  
pp. 1035-1038 ◽  
Author(s):  
Balázs Forgács
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Multidisciplinary Approach ◽  
Pulmonary Metastases ◽  
Interdisciplinary Approach ◽  
Thoracic Ct ◽  
Upper And Lower Extremities ◽  
The Right ◽  
Thoracic Ct Scan ◽  
Very High

Mafucci’s syndrome is a rare genetic but non-hereditary disorder, characterized by multiple enchondromas (enchondromatosis), hemangiomas and, rarely, lymphangiomas. The risk for malignant transformation of enchondromas is very high, and chondrosarcomas can develop which mainly metastatize to the lungs. A case report of a 61-years-old male, whose enchondromatosis developed at his age of 10 years, is described. The initial diagnosis had been Ollier’s disease at that time, and it was modified to Mafucci’s syndrome only in 1995 when hemangiomatosis developed on the right hand. He had a unilateral disorder affecting his right upper and lower extremities. In 2010, a chondrosarcoma developed on his right leg and amputation was performed. In 2012, a thoracic CT scan revealed pulmonary metastases on both sides. This case report underlines the importance of the multidisciplinary approach and cooperation between various specialties in diagnosing and early detecting this type of cancer. Orv. Hetil., 2012, 153, 1035–1038.

scholarly journals Pulmonary Artery Diameter on Thoracic CT Scan and Its Relationship to Pulmonary Artery Pressure

CHEST Journal ◽  
2012 ◽  
Vol 142 (4) ◽  
pp. 823A
Author(s):  
Mohammad Khalid ◽  
Sarfraz Saleemi ◽  
Abdullah AlDalaan ◽  
Mohammad Zeitouni ◽  
Abdullah Mobeireek ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Ct Scan ◽  
Pulmonary Artery Pressure ◽  
Artery Pressure ◽  
Thoracic Ct ◽  
Thoracic Ct Scan ◽  
Pulmonary Artery Diameter

Direct Access Thoracic CT Scan: Impact of Change in Pathway on Wait Times

CHEST Journal ◽  
2015 ◽  
Vol 148 (4) ◽  
pp. 557A
Author(s):  
Jayanth Bhat ◽  
Javed Ibrahim ◽  
Subashini Chandrapalan ◽  
Ashwin Rajhan ◽  
Nick Watson ◽  
...  
Keyword(s):  
Ct Scan ◽  
Direct Access ◽  
Wait Times ◽  
Thoracic Ct ◽  
Thoracic Ct Scan

Should mechanical ventilation be optimized to blood gases, lung mechanics, or thoracic CT scan?

1995 ◽  
Vol 152 (2) ◽  
pp. 524-530 ◽  
Author(s):  
F Brunet ◽  
D Jeanbourquin ◽  
M Monchi ◽  
J P Mira ◽  
L Fierobe ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Ct Scan ◽  
Blood Gases ◽  
Lung Mechanics ◽  
Thoracic Ct ◽  
Thoracic Ct Scan

scholarly journals Circulating Vitamin D levels status and clinical prognostic indices in COVID-19 patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alberto Ricci ◽  
Alessandra Pagliuca ◽  
Michela D’Ascanio ◽  
Marta Innammorato ◽  
Claudia De Vitis ◽  
...  
Keyword(s):  
Vitamin D ◽  
T Lymphocytes ◽  
Immune Responses ◽  
Ct Scan ◽  
Vitamin D Deficiency ◽  
Plasma Levels ◽  
Cd8 T Lymphocytes ◽  
Thoracic Ct ◽  
Vitamin D Levels ◽  
Thoracic Ct Scan

Abstract Background Several immune mechanisms activate in COVID-19 pathogenesis. Usually, coronavirus infection is characterized by dysregulated host immune responses, interleukine-6 increase, hyper-activation of cytotoxic CD8 T lymphocytes. Interestingly, Vitamin D deficiency has been often associated with altered immune responses and infections. In the present study, we evaluated Vitamin D plasma levels in patients affected with different lung involvement during COVID-19 infection. Methods Lymphocyte phenotypes were assessed by flow cytometry. Thoracic CT scan involvement was obtained by an image analysis program. Results Vitamin D levels were deficient in (80%) of patients, insufficient in (6.5%) and normal in (13.5%). Patients with very low Vitamin D plasma levels had more elevated D-Dimer values, a more elevated B lymphocyte cell count, a reduction of CD8 + T lymphocytes with a low CD4/CD8 ratio, more compromised clinical findings (measured by LIPI and SOFA scores) and thoracic CT scan involvement. Conclusions Vitamin D deficiency is associated with compromised inflammatory responses and higher pulmonary involvement in COVID-19 affected patients. Vitamin D assessment, during COVID-19 infection, could be a useful analysis for possible therapeutic interventions. Trial registration: 'retrospectively registered'.

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