scholarly journals 3D Printing—A Cutting Edge Technology for Treating Post-Infarction Patients

Life ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 910
Author(s):  
Daniel Cernica ◽  
Imre Benedek ◽  
Stefania Polexa ◽  
Cosmin Tolescu ◽  
Theodora Benedek

The increasing complexity of cardiovascular interventions requires advanced peri-procedural imaging and tailored treatment. Three-dimensional printing technology represents one of the most significant advances in the field of cardiac imaging, interventional cardiology or cardiovascular surgery. Patient-specific models may provide substantial information on intervention planning in complex cardiovascular diseases, and volumetric medical imaging from CT or MRI can be translated into patient-specific 3D models using advanced post-processing applications. 3D printing and additive manufacturing have a great variety of clinical applications targeting anatomy, implants and devices, assisting optimal interventional treatment and post-interventional evaluation. Although the 3D printing technology still lacks scientific evidence, its benefits have been shown in structural heart diseases as well as for treatment of complex arrhythmias and corrective surgery interventions. Recent development has enabled transformation of conventional 3D printing into complex 3D functional living tissues contributing to regenerative medicine through engineered bionic materials such hydrogels, cell suspensions or matrix components. This review aims to present the most recent clinical applications of 3D printing in cardiovascular medicine, highlighting also the potential for future development of this revolutionary technology in the medical field.

2016 ◽  
Vol 12 (2-3) ◽  
Author(s):  
Giovanni Biglino ◽  
Claudio Capelli ◽  
Lindsay-Kay Leaver ◽  
Silvia Schievano ◽  
Andrew M. Taylor ◽  
...  

Objective: To evaluate the usefulness of 3D printing patient-specific models of congenital heart disease (CHD) from the perspective of different stakeholders potentially benefiting from the technology (patients, parents, clinicians and nurses). Methods: Workshops, focus groups and teaching sessions were organized, each targeting a different group of stakeholders. Sessions involved displaying and discussing different 3D models of CHD. Model evaluation involved questionnaires, audio-recorded discussions and written feedback. Results: All stakeholders expressed a liking for the 3D models and for the patient-specific quality of such models. Patients indicated that 3D models can help them imagine “what’s going on inside” and parents agreed that these tools can spark curiosity in the young people. Clinicians indicated that teaching might be the most relevant application of such novel technology and nurses agreed that 3D models improved their learning experience during a course focused on CHD. Conclusion: The successful engagement of different stakeholders to evaluate 3D printing technology for CHD identified different priorities, highlighting the importance of eliciting the views of different groups. Practice Implications: A PPI-based approach in the evaluation and translation of 3D printing technology may increase patient empowerment, improve patient-doctor communication and provide better access to a new teaching and training tool.


Author(s):  
E. Nocerino ◽  
F. Remondino ◽  
F. Uccheddu ◽  
M. Gallo ◽  
G. Gerosa

In the last years, cardiovascular diagnosis, surgical planning and intervention have taken advantages from 3D modelling and rapid prototyping techniques. The starting data for the whole process is represented by medical imagery, in particular, but not exclusively, computed tomography (CT) or multi-slice CT (MCT) and magnetic resonance imaging (MRI). On the medical imagery, regions of interest, i.e. heart chambers, valves, aorta, coronary vessels, etc., are segmented and converted into 3D models, which can be finally converted in physical replicas through 3D printing procedure. In this work, an overview on modern approaches for automatic and semiautomatic segmentation of medical imagery for 3D surface model generation is provided. The issue of accuracy check of surface models is also addressed, together with the critical aspects of converting digital models into physical replicas through 3D printing techniques. A patient-specific 3D modelling and printing procedure (Figure 1), for surgical planning in case of complex heart diseases was developed. The procedure was applied to two case studies, for which MCT scans of the chest are available. In the article, a detailed description on the implemented patient-specific modelling procedure is provided, along with a general discussion on the potentiality and future developments of personalized 3D modelling and printing for surgical planning and surgeons practice.


2021 ◽  
Vol 7 ◽  
Author(s):  
Jasamine Coles-Black ◽  
Damien Bolton ◽  
Jason Chuen

Introduction: 3D printed patient-specific vascular phantoms provide superior anatomical insights for simulating complex endovascular procedures. Currently, lack of exposure to the technology poses a barrier for adoption. We offer an accessible, low-cost guide to producing vascular anatomical models using routine CT angiography, open source software packages and a variety of 3D printing technologies.Methods: Although applicable to all vascular territories, we illustrate our methodology using Abdominal Aortic Aneurysms (AAAs) due to the strong interest in this area. CT aortograms acquired as part of routine care were converted to representative patient-specific 3D models, and then printed using a variety of 3D printing technologies to assess their material suitability as aortic phantoms. Depending on the technology, phantoms cost $20–$1,000 and were produced in 12–48 h. This technique was used to generate hollow 3D printed thoracoabdominal aortas visible under fluoroscopy.Results: 3D printed AAA phantoms were a valuable addition to standard CT angiogram reconstructions in the simulation of complex cases, such as short or very angulated necks, or for positioning fenestrations in juxtarenal aneurysms. Hollow flexible models were particularly useful for device selection and in planning of fenestrated EVAR. In addition, these models have demonstrated utility other settings, such as patient education and engagement, and trainee and anatomical education. Further study is required to establish a material with optimal cost, haptic and fluoroscopic fidelity.Conclusion: We share our experiences and methodology for developing inexpensive 3D printed vascular phantoms which despite material limitations, successfully mimic the procedural challenges encountered during live endovascular surgery. As the technology continues to improve, 3D printed vascular phantoms have the potential to disrupt how endovascular procedures are planned and taught.


2018 ◽  
Vol 9 (4) ◽  
pp. 454-458 ◽  
Author(s):  
Sarah A. Chen ◽  
Chin Siang Ong ◽  
Nagina Malguria ◽  
Luca A. Vricella ◽  
Juan R. Garcia ◽  
...  

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.


Cardiology ◽  
2016 ◽  
Vol 135 (4) ◽  
pp. 255-261 ◽  
Author(s):  
Peng Liu ◽  
Rijing Liu ◽  
Yan Zhang ◽  
Yingfeng Liu ◽  
Xiaoming Tang ◽  
...  

Aims and Objectives: The objective of this study was to assess the clinical feasibility of generating 3D printing models of left atrial appendage (LAA) using real-time 3D transesophageal echocardiogram (TEE) data for preoperative reference of LAA occlusion. Background: Percutaneous LAA occlusion can effectively prevent patients with atrial fibrillation from stroke. However, the anatomical structure of LAA is so complicated that adequate information of its structure is essential for successful LAA occlusion. Emerging 3D printing technology has the demonstrated potential to structure more accurately than conventional imaging modalities by creating tangible patient-specific models. Typically, 3D printing data sets are acquired from CT and MRI, which may involve intravenous contrast, sedation, and ionizing radiation. It has been reported that 3D models of LAA were successfully created by the data acquired from CT. However, 3D printing of the LAA using real-time 3D TEE data has not yet been explored. Methods: Acquisition of 3D transesophageal echocardiographic data from 8 patients with atrial fibrillation was performed using the Philips EPIQ7 ultrasound system. Raw echocardiographic image data were opened in Philips QLAB and converted to ‘Cartesian DICOM' format and imported into Mimics® software to create 3D models of LAA, which were printed using a rubber-like material. The printed 3D models were then used for preoperative reference and procedural simulation in LAA occlusion. Results: We successfully printed LAAs of 8 patients. Each LAA costs approximately CNY 800-1,000 and the total process takes 16-17 h. Seven of the 8 Watchman devices predicted by preprocedural 2D TEE images were of the same sizes as those placed in the real operation. Interestingly, 3D printing models were highly reflective of the shape and size of LAAs, and all device sizes predicted by the 3D printing model were fully consistent with those placed in the real operation. Also, the 3D printed model could predict operating difficulty and the presence of a peridevice leak. Conclusions: 3D printing of the LAA using real-time 3D transesophageal echocardiographic data has a perfect and rapid application in LAA occlusion to assist with physician planning and decision making.


2021 ◽  
Author(s):  
Jiang long Guo ◽  
Hong yi Li ◽  
Kui Zhao ◽  
Meng Zhang ◽  
Jing zhi Ye ◽  
...  

Abstract Purpose To comparethe effectiveness of the three-dimensional (3D) printing technology in the treatment of clavicularfracturebetween experienced and inexperienced orthopedic surgeons. Methods A total of 80 patients with clavicle fracture (from February 2017 to May 2021)were enrolled in our study. Patients were divided randomly into four groups: group A: Patients underwent low-dose CT scan and 3D models were printed before surgeries performed by inexperienced surgeons; group B: Standard-dose CT were taken and 3D models were printed before surgeries performed by experienced surgeons; group C and D: Standard-dose CT were taken in both groups, and the operations were performed differently by inexperienced (group C) and experienced (group D) surgeons. Operation time, blood loss, length of incision and number of intraoperative fluoroscopy were recorded. Results No statistically significant differences were found in age, gender, fracture site and fracture type (P value: 0.23–0.88).Group A showed shorter incision length and less intraoperative fluoroscopy times than group C and D (P value < 0.05). There were no significant differences in blood loss volume, incision length and number of intraoperative time between group A and group B (P value range: 0.11–0.28). The operation time of group A was no longer than that of group C and D (P value range: 0.11 and 0.24). Conclusion The surgical effectiveness of inexperienced surgeons who applied 3D printing technology before clavicular fracture operation were better than those of both inexperienced and experienced surgeons did not use preoperative 3D printing technology.


Author(s):  
Enrico Ferrari ◽  
Michele Gallo ◽  
Changtian Wang ◽  
Lei Zhang ◽  
Maurizio Taramasso ◽  
...  

Abstract Three-dimensional (3D)-printing technologies in cardiovascular surgery have provided a new way to tailor surgical and percutaneous treatments. Digital information from standard cardiac imaging is integrated into physical 3D models for an accurate spatial visualization of anatomical details. We reviewed the available literature and analysed the different printing technologies, the required procedural steps for 3D prototyping, the used cardiac imaging, the available materials and the clinical implications. We have highlighted different materials used to replicate aortic and mitral valves, vessels and myocardial properties. 3D printing allows a heuristic approach to investigate complex cardiovascular diseases, and it is a unique patient-specific technology providing enhanced understanding and tactile representation of cardiovascular anatomies for the procedural planning and decision-making process. 3D printing may also be used for medical education and surgical/transcatheter training. Communication between doctors and patients can also benefit from 3D models by improving the patient understanding of pathologies. Furthermore, medical device development and testing can be performed with rapid 3D prototyping. Additionally, widespread application of 3D printing in the cardiovascular field combined with tissue engineering will pave the way to 3D-bioprinted tissues for regenerative medicinal applications and 3D-printed organs.


2021 ◽  
Vol 2 (2) ◽  
pp. 289-302
Author(s):  
Antreas Kantaros ◽  
Dimitrios Piromalis

Over time, the fabrication of lattice, porous structures has always been a controversial field for researchers and practitioners. Such structures could be fabricated in a stochastic way, thus, with limited control over the actual porosity percentage. The emerging technology of 3D printing, offered an automated process that did not require the presence of molds and operated on a layer-by-layer deposition basis, provided the ability to fabricate almost any shape through a variety of materials and methods under the umbrella of the ASTM terminology “additive manufacturing”. In the field of biomedical engineering, the technology was embraced and adopted for relevant applications, offering an elevated degree of design freedom. Applications range in the cases where custom-shaped, patient-specific items have to be produced. Scaffold structures were already a field under research when 3D printing was introduced. These structures had to act as biocompatible, bioresorbable and biodegradable substrates, where the human cells could attach and proliferate. In this way, tissue could be regenerated inside the human body. One of the most important criteria for such a structure to fulfil is the case-specific internal geometry design with a controlled porosity percentage. 3D printing technology offered the ability to tune the internal porosity percentage with great accuracy, along with the ability to fabricate any internal design pattern. In this article, lattice scaffold structures for tissue regeneration are overviewed, and their evolution upon the introduction of 3D printing technology and its employment in their fabrication is described.


Author(s):  
Umar F Samdani ◽  
Steven W Hwang

The revolutionary technology of 3D printing has gained traction in the medical field in recent years; spine surgery has in particular seen major advances in 3D printing. The applications of this technology have grown from utilizing 3D models to enhance patient education to patient specific, highly detailed intraoperative anatomical molds. However, obstacles remain that prevent the widespread utilization of 3D printing in spine surgery such as cost, time consumption, lack of long-term data, and regulation by the US FDA. Despite these obstacles, it is evident that 3D printing will be utilized to optimize preoperative, intraoperative, and postoperative care of patients with spine deformity. The purpose of this review is to establish the applications of 3D printing for spine surgery.


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