Medical School, College of Medicine and Health, Exeter, UK.
Department of Engineering, College of Engineering, Mathematics, and Physical Sciences, University of Exeter, Exeter, UK.
Biomed Eng Online. 2022 Sep 1;21(1):59. doi: 10.1186/s12938-022-01029-z.
Recently, transcatheter aortic valve replacement (TAVR) has been suggested as a less invasive treatment compared to surgical aortic valve replacement, for patients with severe aortic stenosis. Despite the attention, persisting evidence suggests that several procedural complications are more prevalent with the transcatheter approach. Consequently, a systematic review was undertaken to evaluate the application of three-dimensional (3D) printing in preoperative planning for TAVR, as a means of predicting and subsequently, reducing the incidence of adverse events.
MEDLINE, Web of Science and Embase were searched to identify studies that utilised patient-specific 3D printed models to predict or mitigate the risk of procedural complications.
13 of 219 papers met the inclusion criteria of this review. The eligible studies have shown that 3D printing has most commonly been used to predict the occurrence and severity of paravalvular regurgitation, with relatively high accuracy. Studies have also explored the usefulness of 3D printed anatomical models in reducing the incidence of coronary artery obstruction, new-onset conduction disturbance and aortic annular rapture.
Patient-specific 3D models can be used in pre-procedural planning for challenging cases, to help deliver personalised treatment. However, the application of 3D printing is not recommended for routine clinical practice, due to practicality issues.
与传统的外科主动脉瓣置换术相比,经导管主动脉瓣置换术(TAVR)作为一种微创治疗方法,目前已被广泛应用于严重主动脉瓣狭窄患者的治疗中。尽管如此,大量证据表明,经导管介入治疗的手术相关并发症更为常见。因此,本研究旨在评估三维(3D)打印技术在 TAVR 术前规划中的应用,以期预测并降低不良事件的发生风险。
我们通过检索 MEDLINE、Web of Science 和 Embase 数据库,筛选出应用患者特异性 3D 打印模型预测或减轻手术并发症风险的研究。
本研究共纳入 219 篇文献,其中 13 篇符合纳入标准。这些研究表明,3D 打印技术最常用于预测瓣周漏的发生和严重程度,预测结果具有较高的准确性。此外,3D 打印解剖模型也被用于降低冠状动脉阻塞、新发传导障碍和主动脉瓣环撕裂等并发症的发生风险。
3D 打印技术可用于复杂病例的术前规划,以实现个体化治疗。但由于实用性问题,3D 打印技术目前不推荐常规应用于临床实践。