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3D 打印、计算建模和人工智能在结构性心脏病中的应用。

3D Printing, Computational Modeling, and Artificial Intelligence for Structural Heart Disease.

机构信息

Center for Structural Heart Disease, Division of Cardiology, Henry Ford Health System, Detroit, Michigan, USA.

Hippocrates Research Lab, Tencent America, Palo Alto, California, USA.

出版信息

JACC Cardiovasc Imaging. 2021 Jan;14(1):41-60. doi: 10.1016/j.jcmg.2019.12.022. Epub 2020 Aug 26.

Abstract

Structural heart disease (SHD) is a new field within cardiovascular medicine. Traditional imaging modalities fall short in supporting the needs of SHD interventions, as they have been constructed around the concept of disease diagnosis. SHD interventions disrupt traditional concepts of imaging in requiring imaging to plan, simulate, and predict intraprocedural outcomes. In transcatheter SHD interventions, the absence of a gold-standard open cavity surgical field deprives physicians of the opportunity for tactile feedback and visual confirmation of cardiac anatomy. Hence, dependency on imaging in periprocedural guidance has led to evolution of a new generation of procedural skillsets, concept of a visual field, and technologies in the periprocedural planning period to accelerate preclinical device development, physician, and patient education. Adaptation of 3-dimensional (3D) printing in clinical care and procedural planning has demonstrated a reduction in early-operator learning curve for transcatheter interventions. Integration of computation modeling to 3D printing has accelerated research and development understanding of fluid mechanics within device testing. Application of 3D printing, computational modeling, and ultimately incorporation of artificial intelligence is changing the landscape of physician training and delivery of patient-centric care. Transcatheter structural heart interventions are requiring in-depth periprocedural understanding of cardiac pathophysiology and device interactions not afforded by traditional imaging metrics.

摘要

结构性心脏病(SHD)是心血管医学领域的一个新兴领域。传统的影像学方法在支持 SHD 介入的需求方面存在不足,因为它们是围绕疾病诊断的概念构建的。SHD 介入打破了传统的影像学概念,需要影像学来规划、模拟和预测术中结果。在经导管 SHD 介入中,缺乏标准的开胸手术视野,使医生无法获得触觉反馈和心脏解剖结构的视觉确认。因此,对术中指导成像的依赖导致了新一代程序技能、视野概念和围手术期规划技术的发展,以加速临床前设备开发、医生和患者教育。3D 打印在临床护理和程序规划中的应用已经证明,经导管介入的早期操作者学习曲线有所缩短。将计算模型集成到 3D 打印中,加速了设备测试中流体力学的研究和开发理解。3D 打印、计算模型的应用,最终包括人工智能的应用,正在改变医生培训和以患者为中心的护理的格局。经导管结构性心脏介入需要深入了解心脏病理生理学和传统影像学指标无法提供的器械相互作用。

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