Scan, plan, print, practice, perform: Development and use of a patient-specific 3-dimensional printed model in adult cardiac surgery
Open accessAbstract
Objective Static 3-dimensional printing is used for operative planning in cases that involve difficult anatomy. An interactive 3D print allowing deliberate surgical practice would represent an advance.Methods Two patients with hypertrophic cardiomyopathy had 3-dimensional prints constructed preoperatively. Stereolithography files were generated by segmentation of chest computed tomographic scans. Prints were made with hydrogel material, yielding tissue-like models that can be surgically manipulated. Septal myectomy of the print was performed preoperatively in the simulation laboratory. Volumetric measures of print and patient resected specimens were compared. An assessment tool was developed and used to rate the utility of this process. Clinical and echocardiographic data were reviewed.Results There was congruence between volumes of print and patient resection specimens (patient 1, 3.5 cm 3 and 3.0 cm 3, respectively; patient 2, 4.0 cm 3 and 4.0 cm 3, respectively). The prints were rated useful (3.5 and 3.6 on a 5-point Likert scale) for preoperative visualization, planning, and practice. Intraoperative echocardiographic assessment showed adequate relief of left ventricular outflow tract obstruction (patient 1, 80 mm Hg to 18 mm Hg; patient 2, 96 mm Hg to 9 mm Hg). Both patients reported symptomatic improvement (New York Heart Association functional class III to class I).Conclusions Three-dimensional printing of interactive hypertrophic cardiomyopathy heart models allows for patient-specific preoperative simulation. Resection volume relationships were congruous on both specimens and suggest evidence of construct validity. This model also holds educational promise for simulation of a low-volume, high-risk operation that is traditionally difficult to teach.
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3D bioprinting can generate models replicating the heart's complex structure with chambers and large vessels using soft biomaterials.
“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 [11]
The 3D Printing section (page not provided) describes patient-specific heart models made from a printed scaffold infused with silicone and hydrogels to mimic myocardial tissue. The Segmentation and Digital Modeling section identifies structures including the aorta and ventricular septum, but the paper does not establish that the models replicate the heart’s full chamber-and-large-vessel structure. It describes 3D printing, not bioprinting. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPrinting tissues composed entirely of native proteins, cells, and/or biocompatible synthetic components is possible and accessible to many laboratories.
“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 [11]
The 3D Printing section (page not provided) describes making a heart model from a proprietary scaffold, silicone, and hydrogels, supporting the narrower point that tissue-like models can be printed. It does not establish that the model is tissue composed of native proteins or cells, that its synthetic components are biocompatible, or that this process is accessible to many laboratories. (LLM, conf=0.83)
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Cites
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The Mitral Valve in Obstructive Hypertrophic Cardiomyopathy
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Kupfer, M. E., Lin, W.-H., Ravikumar, V., Qiu, K., Wang, L., Gao, L., Bhuiyan, D. B., Lenz, M., Ai, J., Mahutga, R. R., et al. (2020) · Circulation Research · doi:10.1161/circresaha.119.316155 · Cited by 329 · see citing works
- Authors
- Hermsen, J. L., Burke, T. M., Seslar, S. P., Owens, D. S., Ripley, B. A., Mokadam, N. A., & Verrier, E. D.
- Affiliations
- University of Washington (US)
- Seattle Children's Hospital (US)
- Corresponding author
- Hermsen, Joshua L.
- Venue
- The Journal of Thoracic and Cardiovascular Surgery
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 153
- Issue
- 1
- Pages
- 132-140
- ISSN
- 0022-5223 (ISSN-L)
- OpenAlex
- W2512815869
- Cited by
- 114
- References
- 12
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 10 · 2023: 8 · 2022: 7 · 2021: 9 · 2020: 17 · 2019: 11 · 2018: 24 · 2017: 20 · 2016: 5
- FWCI
- 9.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Anatomy and Medical Technology
- Health Sciences › Medicine › Surgery › Surgical Simulation and Training
- Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
- Keywords
- 3D printing, hypertrophic cardiomyopathy, preoperative surgical planning, surgical simulation, septal myectomy, left ventricular outflow tract obstruction, patient-specific cardiac models, stereolithography, surgical training
- MeSH terms
- Cardiomyopathy, Hypertrophic, Female, Heart Failure, Humans, Middle Aged, Models, Anatomic, Models, Cardiovascular, Tomography, X-Ray Computed, Treatment Outcome, Echocardiography, Transesophageal, Recovery of Function, Uterine Myomectomy, Patient-Specific Modeling, Printing, Three-Dimensional
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