Apr 27, 2018 | By David
A recent study has explored the effectiveness of using 3D printing technology as part of treatment for a heart condition. The study’s lead author was Sergey Gurevich, MD, and Cardiovascular Fellow at the University of Minnesota in Minneapolis, MN. His team made use of 3D printed heart models based on CT scans of patients who are undergoing transcatheter aortic valve replacement, in order to predict and prevent paravalvular leak (PVL). PVL is a relatively common issue that results from an ill-fitting valve, and has a huge impact on heart surgery-related mortality rates.
(credit: Yael L. Maxwell, TCTMD)
Each year, over five million Americans are diagnosed with heart valve disease. TAVR is a surgical procedure that is used for patients classified as intermediate, high-risk, and inoperable. In cases where they have severe narrowing of their aortic valve, a prosthetic valve can be implanted and the damaged one is removed and replaced. Clinicians have been trying for years to improve the success rate of these procedures by preventing PVL, and a new approach that makes use of 3D printing technology looks to be a promising solution.
(source: northshore.org)
In the study, six patients who were undergoing TAVR for severe calcific aortic stenosis, and who were particularly at risk for PVL, had their pre-procedure CT (computed tomography) images analyzed. These CT scans were then sliced up ready for printing of physical 3D models. The surgeons then examined these replica heart models to evaluate their replacement valves. The valves were implanted directly into the 3D printed models to determine if it was a correct size and how the fit would be, and where the calcium deposits would be located.
These models were then 3D scanned and evaluated further, with comparison to the real in-vivo implanted TAVR echocardiograms. The CT scans confirmed every prediction made based on the 3D printed model. The success of this study points the way forward for the same technique to be used more regularly in TAVR procedures, in order to personalize valve placement, size, and location, to stop leaks and lower calcium build up.
(source: AHA Journals)
"We are very encouraged to see such positive outcomes for the feasibility of 3D printing in patients with heart valve disease. These patients are at a high risk of developing a leak after TAVR, and anything we can do to identify and prevent these leaks from happening is certainly helpful," said Gurevich. "Like any other new technology, as 3D printing evolves, we hope to see an increase in accessibility and opportunity for the use of this technology to help improve patient care."
The future of this research is bright, and it joins a growing body of successful studies where 3D printed surgical models have been used to improve the effectiveness of procedures. The technology is fast and affordable to use, and its detailed, accurate replication of individual anatomy allows surgeons to prevent, fix and foresee procedural errors. For this particular surgical field, the team are now starting to work with computational fluid dynamics systems in order to further optimize calculations.
The study, "3D Printing and Computer Modeling to Predict Paravalvular Leak in Transcatheter Aortic Valve Replacement", will be presented at the Society for Cardiovascular Angiography and Interventions Scientific Sessions, April 25-28, 2018, in San Diego.
Posted in 3D Printing Application
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