Liu Yuanzhang, Mao Yu, Wang Yiwei, Jin Ping, Zhai Mengen, Liu Yang, Yang Jian
Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi'an 710032, China.
Bioengineering (Basel). 2025 Mar 26;12(4):344. doi: 10.3390/bioengineering12040344.
Severe pulmonary regurgitation (PR) often occurs after treatment of tetralogy of Fallot with a valve ring patch, leading to enlargement and diverse morphological characteristics of the native right ventricular outflow tract (nRVOT), which increases the difficulty of transcatheter pulmonary valve replacement (TPVR). The purpose of this study was to use the TPVR simulator to help doctors improve their surgical skills by simulating the surgical process in vitro.
The TPVR simulator was developed using three-dimensional (3D) printing technology under computer-aided design. In this study, the TPVR simulator was used for preoperative simulation training and teaching. First, 10 specialists were equally divided into a 3D-printed group and a non-3D-printed group, each performing one TPVR; then, another six specialists and six young surgeons were selected to complete three TPVR simulations.
For the 3D-printed simulation group, the over-flap time (5.22 min (range: 4.85-5.87 min) vs. 6.72 min (range: 6.12-7.70 min), = 0.016), fluoroscopy time (15.00 min (range: 13.50-16.50 min) vs. 19.00 min (range: 17.50-21.50 min), = 0.012), and total operative time for the five surgeons (57.00 min (range: 54.00-62.50 min) vs. 67.00 min (range: 62.00-69.50 min), = 0.036) were shorter. In addition, the results showed significant reductions in the median over-flap time and total time required in both the expert panel and young surgeon groups (all < 0.05).
The reliability and validity of the TPVR simulator was initially demonstrated and has the potential to be a teaching and training tool for surgeons.
法洛四联症采用带瓣环补片治疗后常出现严重肺动脉反流（PR），导致原生右心室流出道（nRVOT）扩大且形态多样，增加了经导管肺动脉瓣置换术（TPVR）的难度。本研究旨在使用TPVR模拟器通过体外模拟手术过程帮助医生提高手术技能。
在计算机辅助设计下利用三维（3D）打印技术开发TPVR模拟器。在本研究中，TPVR模拟器用于术前模拟训练和教学。首先，将10名专家平均分为3D打印组和非3D打印组，每组进行一次TPVR；然后，再选择另外6名专家和6名年轻外科医生完成三次TPVR模拟。
对于3D打印模拟组，瓣膜翻转时间（5.22分钟（范围：4.85 - 5.87分钟）对6.72分钟（范围：6.12 - 7.70分钟），P = 0.016）、透视时间（15.00分钟（范围：13.50 - 16.50分钟）对19.00分钟（范围：17.50 - 21.50分钟），P = 0.012）以及五名外科医生的总手术时间（57.00分钟（范围：54.00 - 62.50分钟）对67.00分钟（范围：62.00 - 69.50分钟），P = 0.036）均较短。此外，结果显示专家小组和年轻外科医生组的瓣膜翻转时间中位数和所需总时间均显著减少（均P < 0.05）。
初步证明了TPVR模拟器的可靠性和有效性，其有潜力成为外科医生的教学和培训工具。
