October 29, 2019 -- The potential benefits of 3D printing and its application in cardiovascular medicine are emerging fast, according to an international group of researchers. They have highlighted examples in four core areas in an article published online on 21 October by Interactive Cardiovascular and Thoracic Surgery.
"3D printing has expanded over the past three decades with growth in both facility implementation and diversity of medical applications," wrote the authors, led by Dr. Enrico Ferrari from Cardiocentro Ticino in Lugano, Switzerland. "The speed of technological development is increasing and the utility of 3D printing and its application in cardiovascular medicine is tangible."
Far and away the most common use of cardiovascular 3D printing has been to facilitate care for pediatric patients with congenital heart diseases, although the application of 3D printing in adult cardiovascular diseases also has been on the rise in recent years.
For the current review article, Ferrari and colleagues searched the Medline database for all available publications on adult cardiovascular 3D printing as of January 2019. The review included 130 3D-printed anatomical models used in the 58 studies examined.
The clinicians performing these studies most often relied upon CT scans to create 3D-printed aortas and aortic valves, whereas they generally used MRI for models replicating vasculature disorders and 3D transesophageal echocardiography for 3D-printed mitral valves and left atrial appendages.
After analyzing the studies, the researchers identified four central applications of adult cardiovascular 3D printing:
Procedural planning and decision-making:Collectively, the studies discussed numerous scenarios in which 3D-printed heart models helped clinicians plan surgical procedures. One scenario that repeatedly arose was using an individually tailored 3D-printed model of the aortic root and valve to simulate transcatheter aortic valve replacement.
Other common cases involved using 3D-printed models to study calcification patterns and valve hemodynamics in patients with severe stenosis, predict annulus ring size and determine the ideal type of leaflet resection before surgery, plan endovascular aortic repairs, and size devices for implantation into the left atrial appendage.
The patient-specific, tactile representation of cardiovascular anatomy in the 3D-printed models was helpful in planning and simulating numerous cardiovascular procedures, the authors noted.
Beyond 3D printing, other advanced imaging techniques have emerged as potential alternatives, such as virtual and augmented reality, fusion technology, and 4D imaging. Yet 3D printing has the distinct advantage of offering a tactile component to visualization, minimizing variation in visual-spatial skills among clinicians and patients, the authors noted.
"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," they concluded.