Guo Hong-Chang, Wang Yang, Dai Jiang, Ren Chang-Wei, Li Jin-Hua, Lai Yong-Qiang
Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100000, China.
Department of Cardiac Surgery, Affiliated Hospital of Hebei University, Baoding 071000, China.
J Thorac Dis. 2018 Feb;10(2):867-873. doi: 10.21037/jtd.2018.01.55.
The aim of this study was to evaluate the effect of 3-dimensional (3D) printing in treatment of hypertrophic obstructive cardiomyopathy (HOCM) and its roles in doctor-patient communication.
3D-printed models were constructed preoperatively and postoperatively in seven HOCM patients received surgical treatment. Based on multi-slice computed tomography (CT) images, regions of disorder were segmented using the Mimics 19.0 software (Materialise, Leuven, Belgium). After generating an STL-file (StereoLithography file) with patients' data, the 3D printer (Objet350 Connex3, Stratasys Ltd., USA) created a 3D model. The pre- and post-operative 3D-printed models were used to make the surgical plan preoperatively and evaluate the outcome postoperatively. Meanwhile, a questionnaire was designed for patients and their relatives to learn the effectiveness of the 3D-printed prototypes in the preoperative conversations.
The heart anatomies were accurately printed with 3D technology. The 3D-printed prototypes were useful for preoperative evaluation, surgical planning, and practice. Preoperative and postoperative echocardiographic evaluation showed left ventricular outflow tract (LVOT) obstruction was adequately relieved (82.71±31.63 to 14.91±6.89 mmHg, P<0.001), the septal thickness was reduced from 21.57±4.65 to 17.42±5.88 mm (P<0.001), and the SAM disappeared completely after the operation. Patients highly appreciated the role of 3D model in preoperative conversations and the communication score was 9.11±0.38 points.
A 3D-printed model is a useful tool in individualized planning for myectomies and represent a useful tool for physician-patient communication.
本研究旨在评估三维（3D）打印在肥厚性梗阻性心肌病（HOCM）治疗中的效果及其在医患沟通中的作用。
对7例接受手术治疗的HOCM患者在术前和术后构建3D打印模型。基于多层计算机断层扫描（CT）图像，使用Mimics 19.0软件（Materialise，比利时鲁汶）对病变区域进行分割。在生成包含患者数据的STL文件（立体光刻文件）后，3D打印机（Objet350 Connex3，美国Stratasys有限公司）创建3D模型。术前和术后的3D打印模型用于术前制定手术方案和术后评估结果。同时，设计了一份问卷用于询问患者及其亲属，以了解3D打印原型在术前沟通中的有效性。
心脏解剖结构通过3D技术被精确打印出来。3D打印原型有助于术前评估、手术规划和练习。术前和术后的超声心动图评估显示左心室流出道（LVOT）梗阻得到充分缓解（从82.71±31.63 mmHg降至14.91±6.89 mmHg，P<0.001），室间隔厚度从21.57±4.65 mm降至17.42±5.88 mm（P<0.001），且术后SAM完全消失。患者高度评价3D模型在术前沟通中的作用，沟通得分为9.11±0.38分。
3D打印模型是肌切除术个体化规划的有用工具，也是医患沟通的有用工具。
