Ravi Prashanth, Burch Michael B, Giannopoulos Andreas A, Liu Isabella, Kondor Shayne, Chepelev Leonid L, Danesi Tommaso H, Rybicki Frank J, Panza Antonio
Department of Radiology, University of Cincinnati, 3188 Bellevue Ave, PO Box 670761, Cincinnati, OH, 45267-0761, USA.
Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
3D Print Med. 2024 Jun 12;10(1):19. doi: 10.1186/s41205-024-00222-1.
Three-dimensional (3D) printing technology has impacted many clinical applications across medicine. However, 3D printing for Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) has not yet been reported in the peer-reviewed literature. The current observational cohort study aimed to evaluate the impact of half scaled (50% scale) 3D printed (3DP) anatomic models in the pre-procedural planning of MIDCAB.
Retrospective analysis included 12 patients who underwent MIDCAB using 50% scale 3D printing between March and July 2020 (10 males, 2 females). Distances measured from CT scans and 3DP anatomic models were correlated with Operating Room (OR) measurements. The measurements were compared statistically using Tukey's test. The correspondence between the predicted (3DP & CT) and observed best InterCostal Space (ICS) in the OR was recorded. Likert surveys from the 3D printing registry were provided to the surgeon to assess the utility of the model. The OR time saved by planning the procedure using 3DP anatomic models was estimated subjectively by the cardiothoracic surgeon.
All 12 patients were successfully grafted. The 3DP model predicted the optimal ICS in all cases (100%). The distances measured on the 3DP model corresponded well to the distances measured in the OR. The measurements were significantly different between the CT and 3DP (p < 0.05) as well as CT and OR (p < 0.05) groups, but not between the 3DP and OR group. The Likert responses suggested high clinical utility of 3D printing. The mean subjectively estimated OR time saved was 40 min.
The 50% scaled 3DP anatomic models demonstrated high utility for MIDCAB and saved OR time while being resource efficient. The subjective benefits over routine care that used 3D visualization for surgical planning warrants further investigation.
三维（3D）打印技术已影响医学领域的许多临床应用。然而，同行评审文献中尚未报道用于微创直接冠状动脉旁路移植术（MIDCAB）的3D打印。当前的观察性队列研究旨在评估半比例（50%比例）3D打印（3DP）解剖模型在MIDCAB术前规划中的影响。
回顾性分析纳入了2020年3月至7月期间使用50%比例3D打印进行MIDCAB的12例患者（10例男性，2例女性）。从CT扫描和3DP解剖模型测量的距离与手术室（OR）测量值相关。使用Tukey检验对测量值进行统计学比较。记录术前预测（3DP和CT）与手术室观察到的最佳肋间间隙（ICS）之间的对应关系。将3D打印登记处的李克特调查问卷提供给外科医生，以评估模型的实用性。心胸外科医生主观估计使用3DP解剖模型规划手术节省的手术室时间。
所有12例患者均成功进行了移植。3DP模型在所有病例中均预测了最佳ICS（100%）。3DP模型上测量的距离与手术室中测量的距离非常吻合。CT组与3DP组以及CT组与OR组之间的测量值存在显著差异（p<0.05），但3DP组与OR组之间无显著差异。李克特回答表明3D打印具有很高的临床实用性。主观估计平均节省的手术室时间为40分钟。
50%比例的3DP解剖模型在MIDCAB中显示出很高的实用性，节省了手术室时间，同时资源高效。与使用3D可视化进行手术规划的常规护理相比，其主观优势值得进一步研究。
