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3D printing based on cardiac CT assists anatomic visualization prior to transcatheter aortic valve replacement
Open accessAbstract
Background 3D printing is a promising technique that may have applications in medicine, and there is expanding interest in the use of patient-specific 3D models to guide surgical interventions.Objective To determine the feasibility of using cardiac CT to print individual models of the aortic root complex for transcatheter aortic valve replacement (TAVR) planning as well as to determine the ability to predict paravalvular aortic regurgitation (PAR).Methods This retrospective study included 16 patients (9 with PAR identified on blinded interpretation of post-procedure trans-thoracic echocardiography and 7 age, sex, and valve size-matched controls with no PAR). 3D printed models of the aortic root were created from pre-TAVR cardiac computed tomography data. These models were fitted with printed valves and predictions regarding post-implant PAR were made using a light transmission test.Results Aortic root 3D models were highly accurate, with excellent agreement between annulus measurements made on 3D models and those made on corresponding 2D data (mean difference of -0.34 mm, 95% limits of agreement: ± 1.3 mm). The 3D printed valve models were within 0.1 mm of their designed dimensions. Examination of the fit of valves within patient-specific aortic root models correctly predicted PAR in 6 of 9 patients (6 true positive, 3 false negative) and absence of PAR in 5 of 7 patients (5 true negative, 2 false positive).Conclusions Pre-TAVR 3D-printing based on cardiac CT provides a unique patient-specific method to assess the physical interplay of the aortic root and implanted valves. With additional optimization, 3D models may complement traditional techniques used for predicting which patients are more likely to develop PAR.
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“Models that replicate the geometrically complex structure of the heart, harboring chambers and large vessels with soft biomaterials, can be achieved using 3D bioprinting.”
From In situ expansion, differentiation, and electromechanical coupling of human cardiac muscle in a 3D bioprinted, chambered organoid (2020) · cites this paper as [13]
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“The concept is gaining traction, as the ability to print tissues composed entirely of native proteins, cells and/or biocompatible synthetic components is possible and accessible to many laboratories9–17.”
From In situ expansion, differentiation, and electromechanical coupling of human cardiac muscle in a 3D bioprinted, chambered organoid (2020) · cites this paper as [13]
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Metadata
- Authors
- Ripley, B., Kelil, T., Cheezum, M. K., Goncalves, A., Di Carli, M. F., Rybicki, F. J., Steigner, M., Mitsouras, D., & Blankstein, R.
- Affiliations
- Brigham and Women's Hospital (US)
- University of Ottawa (CA)
- Corresponding author
- Blankstein, Ron
- Venue
- Journal of Cardiovascular Computed Tomography
- Publisher
- Elsevier BV
- Published
- 2016-01
- Volume
- 10
- Issue
- 1
- Pages
- 28-36
- ISSN
- 1876-861X (ISSN-L)
- 1934-5925
- PMC
- PMC5573584
- OpenAlex
- W2213274111
- Cited by
- 205
- References
- 28
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 12 · 2023: 15 · 2022: 17 · 2021: 18 · 2020: 31 · 2019: 23 · 2018: 29 · 2017: 36 · 2016: 11
- FWCI
- 18.44
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of cardiovascular computed tomography (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Biomedical Imaging and Bioengineering (K01EB015868)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Physical Sciences › Engineering › Biomedical Engineering › Anatomy and Medical Technology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
- Keywords
- 3D printing, transcatheter aortic valve implantation, paravalvular aortic regurgitation, aortic root, patient-specific 3D models, cardiac CT, surgical planning, valve sizing, aortic annulus measurement
- MeSH terms
- Aged, Aged, 80 and over, Aortic Valve, Aortic Valve Insufficiency, Aortography, Computer Simulation, Female, Heart Valve Prosthesis, Humans, Male, Models, Anatomic, Models, Cardiovascular, Prosthesis Design, Tomography, X-Ray Computed, User-Computer Interface, Treatment Outcome, Prosthesis Fitting, Equipment Failure Analysis, Imaging, Three-Dimensional, Transcatheter Aortic Valve Replacement, Patient-Specific Modeling, Printing, Three-Dimensional
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