3D printing of the aortic annulus based on cardiovascular computed tomography: Preliminary experience in pre-procedural planning for aortic valve sizing
3D printing of the aortic annulus based on cardiovascular computed tomography: Preliminary experience in pre-procedural planning for aortic valve sizing
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DOI：
10.1016/j.jcct.2018.05.016
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发表时间：
2018-09-01
影响因子：
5.4
通讯作者：
Fonio, Paolo
中科院分区：
文献类型：
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作者：
Faletti, Riccardo;Gatti, Marco;Fonio, Paolo
背景资料：方法：回顾性分析20例接受主动脉瓣置换术（AVR）的患者的记录，术前通过CCT评估主动脉瓣环，术中通过Hegar扩张器（IOS）测量主动脉瓣环尺寸。通过热塑性聚氨酯长丝的熔融沉积建模来制造3D模型。对于每个患者，两个3D模型由两个盲“制造商”独立分割、建模和打印：一个放射科医生和一个放射科技术员。两名设盲的心脏外科医生使用Hegar扩张器对两组模型进行瓣环直径测量。结果：每位心脏外科医生在同一3D模型（p = 0.48）或不同制造商打印的3D模型（p = 0.25）上进行的测量结果之间无显著差异;观察者内也无差异（p - 0.46）。在3D模型上测量的瓣环直径与参考CCT测量值（p = 0.68）和IOH测量值（p = 0.11）一致。每个模型的时间和成本为：模型创建类似于10-15 min;打印时间类似于60 min;后处理类似于5 min;材料成本-1（SIC）。结论：主动脉瓣环的3D打印可以提供可靠的、不昂贵的患者特定信息，用于AVR或经导管主动脉瓣植入术（TAVI）的术前规划。
Background: to determine reliability and reproducibility of measurements of aortic annulus in 3D models printed from cardiovascular computed tomography (CCT) images.Methods: Retrospective study on the records of 20 patients who underwent aortic valve replacement (AVR) with pre-surgeryannulus assessment by CCT and intra-operative sizing by Hegar dilators (IOS). 3D models were fabricated by fused deposition modelling of thermoplastic polyurethane filaments. For each patient, two 3D models were independently segmented, modelled and printed by two blinded "manufacturers": a radiologist and a radiology technician. Two blinded cardiac surgeons performed the annulus diameter measurements by Hegar dilators on the two sets of models. Matched data from different measurements were analyzed with Wilcoxon test, Bland-Altmann plot and within-subject ANOVA.Results: No significant differences were found among the measurements made by each cardiac surgeon on the same 3D model (p = 0.48) or on the 3D models printed by different manufacturers (p = 0.25); also, no in-traobserver variability (p - 0.46). The annulus diameter measured on 3D models showed good agreement with the reference CCT measurement (p = 0.68) and IOH sizing (p = 0.11). Time and cost per model were: model creation similar to 10-15 min; printing time similar to 60 min; post-processing similar to 5min; material cost - 1(SIC).Conclusion: 3D printing of aortic annulus can offer reliable, not expensive patient-specific information to be used in the pre-operative planning of AVR or transcatheter aortic valve implantation (TAVI).