Chen Sarah A, Ong Chin Siang, Malguria Nagina, Vricella Luca A, Garcia Juan R, Hibino Narutoshi
1 Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
2 Department of Art as Applied to Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
World J Pediatr Congenit Heart Surg. 2018 Jul;9(4):454-458. doi: 10.1177/2150135118771323.
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.
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.
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.
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.
左心发育不全综合征(HLHS)患者的主动脉弓形态多样。重建主动脉弓的几何形状欠佳可能是由于植入补片的尺寸和形状不合适,并且可能与不良预后相关。同时,诊断成像、计算机辅助设计和三维(3D)打印技术的进步使得3D模型的创建成为可能。本研究的目的是创建一个用于主动脉弓重建的手术模拟和训练模型。
使用专门的分割软件从HLHS计算机断层扫描图像中分离出主动脉弓解剖结构,以创建数字3D模型。使用三维建模软件修改导出的分割模型,并数字化设计可打印的定制补片,其尺寸适合于弓重建。
对HLHS主动脉弓解剖结构的实物大小模型和数字化衍生的定制补片进行3D打印,以模拟手术缝合和重建。患者特异性定制补片成功用于手术模拟。
已证明针对主动脉弓重建进行患者特异性补片的数字化设计和3D打印的可行性。该技术有助于手术模拟。导致理解最佳主动脉补片几何形状的手术训练是可能潜在影响HLHS患者预后的一个因素。