Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA.
Division of Cardiothoracic Anesthesiology, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
Curr Cardiol Rep. 2020 Feb 17;22(4):23. doi: 10.1007/s11886-020-1276-8.
A combination of evolving 3D printing technologies, new 3D printable materials, and multi-disciplinary collaborations have made 3D printing applications for transcatheter aortic valve replacement (TAVR) a promising tool to promote innovation, increase procedural success, and provide a compelling educational tool. This review synthesizes the knowledge via publications and our group's experience in this area that exemplify uses of 3D printing for TAVR.
Patient-specific 3D-printed models have been used for TAVR pre-procedural device sizing, benchtop prediction of procedural complications, planning for valve-in-valve and bicuspid aortic valve procedures, and more. Recent publications also demonstrate how 3D printing can be used to test assumptions about why certain complications occur during THV implantation. Finally, new materials and combinations of existing materials are starting to bridge the large divide between current 3D material and cardiac tissue properties. Several studies have demonstrated the utility of 3D printing in understanding challenges of TAVR. Innovative approaches to benchtop testing and multi-material printing have brought us closer to being able to predict how a THV will interact with a specific patient's aortic anatomy. This work to date is likely to open the door for advancements in other areas of structural heart disease, such as interventions involving the mitral valve, tricuspid valve, and left atrial appendage.
不断发展的 3D 打印技术、新型 3D 可打印材料以及多学科合作,使 3D 打印技术在经导管主动脉瓣置换术(TAVR)中的应用成为促进创新、提高手术成功率和提供引人入胜的教育工具的有前途的手段。本文通过出版物和我们在该领域的经验综合了这方面的知识,这些经验体现了 3D 打印在 TAVR 中的应用。
患者特异性 3D 打印模型已用于 TAVR 术前器械尺寸测量、经导管主动脉瓣置换术(TAVR)过程中并发症的台架预测、瓣中瓣和二叶式主动脉瓣手术的规划等。最近的出版物还展示了 3D 打印如何用于测试关于为什么在 THV 植入过程中会发生某些并发症的假设。最后,新材料和现有材料的组合开始缩小当前 3D 材料与心脏组织特性之间的巨大差距。多项研究已经证明了 3D 打印在理解 TAVR 挑战方面的实用性。创新的台架测试和多材料打印方法使我们更接近于能够预测 THV 将如何与特定患者的主动脉解剖结构相互作用。迄今为止的这项工作可能为结构性心脏病的其他领域的进展打开大门,例如涉及二尖瓣、三尖瓣和左心耳的介入。