使用图像衍生的3D打印心脏模型对经导管边缘对边缘修复进行物理模拟。
Physical Simulation of Transcatheter Edge-to-Edge Repair using Image-Derived 3D Printed Heart Models.
作者信息
Ching Stephen, Cianciulli Alana R, Flynn Maura, Silvestro Elizabeth, Sabin Patricia, Lasso Andras, Ghosh Reena M, Gillespie Matthew J, Jolley Matthew A
机构信息
Children's Hospital of Philadelphia, Department of Anesthesia and Critical Care, Philadelphia, PA.
Children's Hospital of Philadelphia, Department of Radiology, Philadelphia, PA.
出版信息
Ann Thorac Surg Short Rep. 2023 Mar;1(1):40-45. doi: 10.1016/j.atssr.2022.09.008. Epub 2022 Sep 23.
BACKGROUND
Transcatheter edge-to-edge valve repair (TEER) is a complex procedure requiring delivery and alignment of the device to the target valve, which can be challenging in atypical or surgically palliated anatomy. We demonstrate application of virtual and physical simulation to plan optimal TEER access and catheter path in normal and congenitally abnormal cardiac anatomy.
METHODS
Three heart models were created from three-dimensional (3D) images and 3D printed, including two with congenital heart disease. TEER catheter course was simulated both virtually and physically using a commercial TEER system.
RESULTS
We demonstrate application of modeling in three patients, including two with congenital heart disease and a Fontan circulation. Access site and pathway to device delivery was simulated by members of a multidisciplinary valve team. Virtual and physical simulation were compared.
CONCLUSIONS
Virtual and physical simulation of TEER using 3D printed heart models is feasible and may be beneficial for planning and simulation, particularly in patients with complex anatomy. Future work is required to demonstrate application in the clinical setting.
背景
经导管缘对缘瓣膜修复术（TEER）是一个复杂的操作，需要将装置输送并对准目标瓣膜，这在非典型或手术姑息性解剖结构中可能具有挑战性。我们展示了虚拟和物理模拟在正常和先天性异常心脏解剖结构中规划最佳TEER入路和导管路径的应用。
方法
从三维（3D）图像创建三个心脏模型并进行3D打印，其中两个患有先天性心脏病。使用商用TEER系统对TEER导管路径进行虚拟和物理模拟。
结果
我们展示了在三名患者中建模的应用，其中两名患有先天性心脏病且有Fontan循环。多学科瓣膜团队成员模拟了装置输送的入路部位和路径。对虚拟和物理模拟进行了比较。
结论
使用3D打印心脏模型对TEER进行虚拟和物理模拟是可行的，可能有助于规划和模拟，特别是在解剖结构复杂的患者中。需要进一步开展工作以证明其在临床环境中的应用。
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