Fan Yiting, Wong Randolph H L, Lee Alex Pui-Wai
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Division of Cardiothoracic Surgery, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Ann Transl Med. 2019 Oct;7(20):579. doi: 10.21037/atm.2019.09.73.
Three-dimensional (3D) printing refers to the process by which physical objects are built by depositing materials in layers based on a specific digital design. It was initially used in manufacture industry. Inspired by the technology, clinicians have recently attempted to integrate 3D printing into medical applications. One of the medical specialties that has recently made such attempt is cardiology, especially in the field of structural heart disease (SHD). SHD refers to a group of non-coronary cardiovascular disorders and related interventions. Obvious examples are aortic stenosis, mitral regurgitation, atrial septal defect, and known or potential left atrial appendage (LAA) clots. In the last decade, cardiologists have witnessed a dramatic increase in the types and complexity of catheter-based interventions for SHD. Current imaging modalities have important limitations in accurate delineation of cardiac anatomies necessary for SHD interventions. Application of 3D printing in SHD interventional planning enables tangible appreciation of cardiac anatomy and allows interventional device testing. 3D printing is used in diagnostic workup, guidance of treatment strategies, and procedural simulation, facilitating hemodynamic research, enhancing interventional training, and promoting patient-clinician communication. In this review, we attempt to define the concept, technique, and work flow of 3D printing in SHD and its interventions, highlighting the reported clinical benefits and unsolved issues, as well as exploring future developments in this field.
三维(3D)打印是指根据特定数字设计通过逐层沉积材料来构建物理对象的过程。它最初用于制造业。受该技术启发,临床医生最近试图将3D打印整合到医学应用中。心脏病学是最近进行此类尝试的医学专科之一,尤其是在结构性心脏病(SHD)领域。SHD是指一组非冠状动脉心血管疾病及相关干预措施。明显的例子有主动脉瓣狭窄、二尖瓣反流、房间隔缺损以及已知或潜在的左心耳(LAA)血栓。在过去十年中,心脏病学家见证了用于SHD的基于导管的干预措施在类型和复杂性方面的显著增加。当前的成像方式在准确描绘SHD干预所需的心脏解剖结构方面存在重要局限性。3D打印在SHD介入规划中的应用能够切实地了解心脏解剖结构,并允许进行介入设备测试。3D打印用于诊断检查、治疗策略指导和程序模拟,有助于血液动力学研究、加强介入培训并促进医患沟通。在本综述中,我们试图定义3D打印在SHD及其干预中的概念、技术和工作流程,强调已报道的临床益处和未解决的问题,并探索该领域的未来发展。