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Opotowsky AR, Khairy P, Diller G, Kasparian NA, Brophy J, Jenkins K, Lopez KN, McCoy A, Moons P, Ollberding NJ, Rathod RH, Rychik J, Thanassoulis G, Vasan RS, Marelli A. Clinical Risk Assessment and Prediction in Congenital Heart Disease Across the Lifespan: JACC Scientific Statement. J Am Coll Cardiol 2024; 83:2092-2111. [PMID: 38777512 DOI: 10.1016/j.jacc.2024.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/12/2024] [Accepted: 02/22/2024] [Indexed: 05/25/2024]
Abstract
Congenital heart disease (CHD) comprises a range of structural anomalies, each with a unique natural history, evolving treatment strategies, and distinct long-term consequences. Current prediction models are challenged by generalizability, limited validation, and questionable application to extended follow-up periods. In this JACC Scientific Statement, we tackle the difficulty of risk measurement across the lifespan. We appraise current and future risk measurement frameworks and describe domains of risk specific to CHD. Risk of adverse outcomes varies with age, sex, genetics, era, socioeconomic status, behavior, and comorbidities as they evolve through the lifespan and across care settings. Emerging technologies and approaches promise to improve risk assessment, but there is also need for large, longitudinal, representative, prospective CHD cohorts with multidimensional data and consensus-driven methodologies to provide insight into time-varying risk. Communication of risk, particularly with patients and their families, poses a separate and equally important challenge, and best practices are reviewed.
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Affiliation(s)
- Alexander R Opotowsky
- Adult Congenital Heart Disease Program, Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
| | - Paul Khairy
- Adult Congenital Heart Centre, Montreal Heart Institute, Montréal, Quebec, Canada
| | - Gerhard Diller
- Department of Cardiology III, University Hospital Münster, Münster, Germany
| | - Nadine A Kasparian
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA; Heart and Mind Wellbeing Center, Cincinnati, Ohio, USA; Heart Institute and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - James Brophy
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada
| | - Kathy Jenkins
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Keila N Lopez
- Department of Pediatrics, Section of Cardiology, Texas Children's Hospital & Baylor College of Medicine, Houston, Texas, USA
| | - Alison McCoy
- Vanderbilt Clinical Informatics Core, Department of Biomedical Informatics, Vanderbilt University Medical Center and Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Nicholas J Ollberding
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Rahul H Rathod
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jack Rychik
- Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - George Thanassoulis
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada
| | - Ramachandran S Vasan
- School of Public Health, University of Texas, San Antonio, Texas, USA; Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Ariane Marelli
- McGill Adult Unit for Congenital Heart Disease Excellence, McGill University, Montreal, Quebec, Canada.
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SUN ZH. Cardiovascular computed tomography in cardiovascular disease: An overview of its applications from diagnosis to prediction. J Geriatr Cardiol 2024; 21:550-576. [PMID: 38948894 PMCID: PMC11211902 DOI: 10.26599/1671-5411.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
Cardiovascular computed tomography angiography (CTA) is a widely used imaging modality in the diagnosis of cardiovascular disease. Advancements in CT imaging technology have further advanced its applications from high diagnostic value to minimising radiation exposure to patients. In addition to the standard application of assessing vascular lumen changes, CTA-derived applications including 3D printed personalised models, 3D visualisations such as virtual endoscopy, virtual reality, augmented reality and mixed reality, as well as CT-derived hemodynamic flow analysis and fractional flow reserve (FFRCT) greatly enhance the diagnostic performance of CTA in cardiovascular disease. The widespread application of artificial intelligence in medicine also significantly contributes to the clinical value of CTA in cardiovascular disease. Clinical value of CTA has extended from the initial diagnosis to identification of vulnerable lesions, and prediction of disease extent, hence improving patient care and management. In this review article, as an active researcher in cardiovascular imaging for more than 20 years, I will provide an overview of cardiovascular CTA in cardiovascular disease. It is expected that this review will provide readers with an update of CTA applications, from the initial lumen assessment to recent developments utilising latest novel imaging and visualisation technologies. It will serve as a useful resource for researchers and clinicians to judiciously use the cardiovascular CT in clinical practice.
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Affiliation(s)
- Zhong-Hua SUN
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, Australia
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth 6012, Australia
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Iqbal N, Fletcher J, Bassett P, Hart A, Lung P, Tozer P. Exploring methods of improving patient understanding and communication in a complex anal fistula clinic: results from a randomized controlled feasibility study. Colorectal Dis 2024; 26:518-526. [PMID: 38235831 DOI: 10.1111/codi.16861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/19/2024]
Abstract
AIM Patient understanding of disease can guide decision-making in the management of anal fistula. This prospective feasibility study aimed to assess the acceptability and methods of assessing the impact of viewing realistic models on patients with anal fistula. METHODS New referrals to a tertiary clinic participated in this single-centre, parallel-group randomized controlled study. Baseline characteristics, Decisional Conflict Scale and understanding of disease were assessed pre-consultation. Participants were randomized to a standard consultation, where disease and treatment options were explained using magnetic resonance images and drawn diagrams, or a similar consultation supplemented with an appropriate generic three-dimensional (3D) printed model. Understanding of disease and proposed surgery, Decisional Conflict Scale and ratings of visual aids were assessed post-consultation, along with 3D model feedback. RESULTS All 52 patients who were approached agreed to be randomized (25 standard, 27 3D consultation). Understanding of disease increased post-consultation in both groups. Post-consultation decisional conflict (0, no; 100, high decisional conflict) was low (median 27 post-standard vs. 24 post-3D consultation). Patients scored highly on measures assessing understanding of proposed surgery. 3D models were rated highly, with 96% of patients wanting to see them again in future consultations. CONCLUSIONS Three-dimensional printed fistula models are a welcome addition to outpatient consultations with results suggesting that understanding of surgery is improved. A future trial should be powered to detect whether 3D models result in a significant improvement in understanding beyond traditional methods of explanation and explore the conditions in which models have their maximal utility. CLINICALTRIALS GOV REGISTRATION ID This study was registered on ClinicalTrials.gov (ID: NCT04069728). Registered on 23 August 2019.
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Affiliation(s)
- Nusrat Iqbal
- Robin Phillips' Fistula Research Unit, St Mark's Hospital, Harrow, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Jordan Fletcher
- Department of Surgery and Cancer, Imperial College London, London, UK
- Department of Colorectal Surgery, St Mark's Hospital, Harrow, UK
| | - Paul Bassett
- Statsconsultancy Ltd, Longwood Lane, Amersham, UK
| | - Ailsa Hart
- Robin Phillips' Fistula Research Unit, St Mark's Hospital, Harrow, UK
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Phillip Lung
- Robin Phillips' Fistula Research Unit, St Mark's Hospital, Harrow, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Phil Tozer
- Robin Phillips' Fistula Research Unit, St Mark's Hospital, Harrow, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
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Sun Z, Silberstein J, Vaccarezza M. Cardiovascular Computed Tomography in the Diagnosis of Cardiovascular Disease: Beyond Lumen Assessment. J Cardiovasc Dev Dis 2024; 11:22. [PMID: 38248892 PMCID: PMC10816599 DOI: 10.3390/jcdd11010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Cardiovascular CT is being widely used in the diagnosis of cardiovascular disease due to the rapid technological advancements in CT scanning techniques. These advancements include the development of multi-slice CT, from early generation to the latest models, which has the capability of acquiring images with high spatial and temporal resolution. The recent emergence of photon-counting CT has further enhanced CT performance in clinical applications, providing improved spatial and contrast resolution. CT-derived fractional flow reserve is superior to standard CT-based anatomical assessment for the detection of lesion-specific myocardial ischemia. CT-derived 3D-printed patient-specific models are also superior to standard CT, offering advantages in terms of educational value, surgical planning, and the simulation of cardiovascular disease treatment, as well as enhancing doctor-patient communication. Three-dimensional visualization tools including virtual reality, augmented reality, and mixed reality are further advancing the clinical value of cardiovascular CT in cardiovascular disease. With the widespread use of artificial intelligence, machine learning, and deep learning in cardiovascular disease, the diagnostic performance of cardiovascular CT has significantly improved, with promising results being presented in terms of both disease diagnosis and prediction. This review article provides an overview of the applications of cardiovascular CT, covering its performance from the perspective of its diagnostic value based on traditional lumen assessment to the identification of vulnerable lesions for the prediction of disease outcomes with the use of these advanced technologies. The limitations and future prospects of these technologies are also discussed.
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Affiliation(s)
- Zhonghua Sun
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia; (J.S.); (M.V.)
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA 6102, Australia
| | - Jenna Silberstein
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia; (J.S.); (M.V.)
| | - Mauro Vaccarezza
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia; (J.S.); (M.V.)
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA 6102, Australia
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Kveller C, Jakobsen AM, Larsen NH, Lindhardt JL, Baad-Hansen T. First experiences of a hospital-based 3D printing facility - an analytical observational study. BMC Health Serv Res 2024; 24:28. [PMID: 38178068 PMCID: PMC10768152 DOI: 10.1186/s12913-023-10511-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024] Open
Abstract
PURPOSE To identify the clinical impact and potential benefits of in-house 3D-printed objects through a questionnaire, focusing on three principal areas: patient education; interdisciplinary cooperation; preoperative planning and perioperative execution. MATERIALS AND METHODS Questionnaires were sent from January 2021 to August 2022. Participants were directed to rate on a scale from 1 to 10. RESULTS The response rate was 43%. The results of the rated questions are averages. 84% reported using 3D-printed objects in informing the patient about their condition/procedure. Clinician-reported improvement in patient understanding of their procedure/disease was 8.1. The importance of in-house placement was rated 9.2. 96% reported using the 3D model to confer with colleagues. Delay in treatment due to 3D printing lead-time was 1.8. The degree with which preoperative planning was altered was 6.9. The improvement in clinician perceived preoperative confidence was 8.3. The degree with which the scope of the procedure was affected, in regard to invasiveness, was 5.6, wherein a score of 5 is taken to mean unchanged. Reduction in surgical duration was rated 5.7. CONCLUSION Clinicians report the utilization of 3D printing in surgical specialties improves procedures pre- and intraoperatively, has a potential for increasing patient engagement and insight, and in-house location of a 3D printing center results in improved interdisciplinary cooperation and allows broader access with only minimal delay in treatment due to lead-time.
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Affiliation(s)
- Christian Kveller
- Department of Orthopedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
| | - Anders M Jakobsen
- Department of Plastic and Breast Surgery, 3D Innovation, Aarhus University Hospital, Aarhus, Denmark
| | - Nicoline H Larsen
- Department of Dentistry, Section for Oral and Maxillofacial Surgery, Aarhus University, Aarhus, Denmark
| | - Joakim L Lindhardt
- Department of Plastic and Breast Surgery, 3D Innovation, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Baad-Hansen
- Department of Orthopedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark
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Marella NT, Gil AM, Fan W, Aristizabal CA, Asrani P, Harrington JK, Channing A, Setton M, Shah AM, Levasseur S, Glickstein J, Farooqi KM. 3D-Printed Cardiac Models for Fetal Counseling: A Pilot Study and Novel Approach to Improve Communication. Pediatr Cardiol 2023; 44:1800-1807. [PMID: 37199756 PMCID: PMC10193324 DOI: 10.1007/s00246-023-03177-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/05/2023] [Indexed: 05/19/2023]
Abstract
A fetal cardiology consultation involves using two-dimensional drawings to explain the cardiac anatomy which can result in inherent variation in how the congenital heart disease (CHD) is conveyed. In this pilot study, we incorporated three-dimensional printed (3DP) models into fetal counseling to demonstrate feasibility and evaluate the impact on parental knowledge, understanding, and anxiety. Parents with a prenatal diagnosis of a muscular ventricular septal defect (VSD) and/or coarctation of aorta were enrolled. Providers were randomized into a Model or Drawing Group and crossed after six months. Parents completed a survey after the consultation which evaluated knowledge of the CHD lesion, expectant surgical management, self-rated understanding, attitude towards the visualization tool, and anxiety. Twenty-nine patients enrolled over a 12 month period. Twelve consultations were done for coarctation of aorta, 13 for VSD, and four for coarctation with a VSD. Both Model and Drawing groups scored similarly in self-reported understanding and confidence, helpfulness of and improvement in communication with the visualization tool. The Model group had higher scores on questions related to the CHD anatomy and surgical intervention [5 [4-5] versus 4 [3.5-5]], p = 0.23 although this didn't reach statistical significance. For the majority (83%) of consultations, the cardiologist agreed that the 3D model improved communication. In this pilot study, we demonstrate the use of 3DP cardiac models during prenatal CHD counseling is feasible and produces results related to parental understanding and knowledge that are equal to and possibly better than the current standard of care.
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Affiliation(s)
- Nicole Toscana Marella
- Division of Pediatric Cardiology, NewYork-Presbyterian/Columbia University Irving Medical Center, 3959 Broadway, CHN-2, New York, NY, 10023, USA
- Division of Pediatric Cardiology, Children's National Hospital, Washington, DC, USA
| | - Adriana Montes Gil
- Division of Pediatric Cardiology, NewYork-Presbyterian/Columbia University Irving Medical Center, 3959 Broadway, CHN-2, New York, NY, 10023, USA
| | - Weijia Fan
- Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Priyanka Asrani
- Division of Pediatric Cardiology, NewYork-Presbyterian/Columbia University Irving Medical Center, 3959 Broadway, CHN-2, New York, NY, 10023, USA
| | - Jamie K Harrington
- Division of Pediatric Cardiology, University of Southern California, Los Angeles, CA, USA
| | - Alexandra Channing
- Division of Pediatric Cardiology, NewYork-Presbyterian/Columbia University Irving Medical Center, 3959 Broadway, CHN-2, New York, NY, 10023, USA
| | - Matan Setton
- Division of Pediatric Cardiology, NewYork-Presbyterian/Columbia University Irving Medical Center, 3959 Broadway, CHN-2, New York, NY, 10023, USA
| | - Amee M Shah
- Division of Pediatric Cardiology, NewYork-Presbyterian/Columbia University Irving Medical Center, 3959 Broadway, CHN-2, New York, NY, 10023, USA
| | - Stéphanie Levasseur
- Division of Pediatric Cardiology, NewYork-Presbyterian/Columbia University Irving Medical Center, 3959 Broadway, CHN-2, New York, NY, 10023, USA
| | - Julie Glickstein
- Division of Pediatric Cardiology, NewYork-Presbyterian/Columbia University Irving Medical Center, 3959 Broadway, CHN-2, New York, NY, 10023, USA
| | - Kanwal M Farooqi
- Division of Pediatric Cardiology, NewYork-Presbyterian/Columbia University Irving Medical Center, 3959 Broadway, CHN-2, New York, NY, 10023, USA.
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7
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Zarrabi A, Perrin D, Kavoosi M, Sommer M, Sezen S, Mehrbod P, Bhushan B, Machaj F, Rosik J, Kawalec P, Afifi S, Bolandi SM, Koleini P, Taheri M, Madrakian T, Łos MJ, Lindsey B, Cakir N, Zarepour A, Hushmandi K, Fallah A, Koc B, Khosravi A, Ahmadi M, Logue S, Orive G, Pecic S, Gordon JW, Ghavami S. Rhabdomyosarcoma: Current Therapy, Challenges, and Future Approaches to Treatment Strategies. Cancers (Basel) 2023; 15:5269. [PMID: 37958442 PMCID: PMC10650215 DOI: 10.3390/cancers15215269] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/18/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
Rhabdomyosarcoma is a rare cancer arising in skeletal muscle that typically impacts children and young adults. It is a worldwide challenge in child health as treatment outcomes for metastatic and recurrent disease still pose a major concern for both basic and clinical scientists. The treatment strategies for rhabdomyosarcoma include multi-agent chemotherapies after surgical resection with or without ionization radiotherapy. In this comprehensive review, we first provide a detailed clinical understanding of rhabdomyosarcoma including its classification and subtypes, diagnosis, and treatment strategies. Later, we focus on chemotherapy strategies for this childhood sarcoma and discuss the impact of three mechanisms that are involved in the chemotherapy response including apoptosis, macro-autophagy, and the unfolded protein response. Finally, we discuss in vivo mouse and zebrafish models and in vitro three-dimensional bioengineering models of rhabdomyosarcoma to screen future therapeutic approaches and promote muscle regeneration.
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Affiliation(s)
- Ali Zarrabi
- Department of Biomedical Engineering, Faculty of Engineering and Natural Sciences, Istinye University, Sariyer, Istanbul 34396, Türkiye; (A.Z.); (A.Z.)
| | - David Perrin
- Section of Orthopaedic Surgery, Department of Surgery, University of Manitoba, Winnipeg, MB R3E 0V9, Canada; (D.P.); (M.S.)
| | - Mahboubeh Kavoosi
- Department of Human Anatomy and Cell Science, University of Manitoba College of Medicine, Winnipeg, MB R3E 0V9, Canada; (M.K.); (B.B.); (F.M.); (J.R.); (P.K.); (S.A.); (S.M.B.); (P.K.); (B.L.); (S.L.); (J.W.G.)
- Biotechnology Center, Silesian University of Technology, 8 Krzywousty St., 44-100 Gliwice, Poland;
| | - Micah Sommer
- Section of Orthopaedic Surgery, Department of Surgery, University of Manitoba, Winnipeg, MB R3E 0V9, Canada; (D.P.); (M.S.)
- Section of Physical Medicine and Rehabilitation, Department of Internal Medicine, University of Manitoba, Winnipeg, MB R3E 0V9, Canada
| | - Serap Sezen
- Faculty of Engineering and Natural Sciences, Sabanci University, Tuzla, Istanbul 34956, Türkiye; (S.S.); (N.C.); (B.K.)
| | - Parvaneh Mehrbod
- Department of Influenza and Respiratory Viruses, Pasteur Institute of Iran, Tehran 1316943551, Iran;
| | - Bhavya Bhushan
- Department of Human Anatomy and Cell Science, University of Manitoba College of Medicine, Winnipeg, MB R3E 0V9, Canada; (M.K.); (B.B.); (F.M.); (J.R.); (P.K.); (S.A.); (S.M.B.); (P.K.); (B.L.); (S.L.); (J.W.G.)
- Department of Anatomy and Cell Biology, School of Biomedical Sciences, Faculty of Science, McGill University, Montreal, QC H3A 0C7, Canada
| | - Filip Machaj
- Department of Human Anatomy and Cell Science, University of Manitoba College of Medicine, Winnipeg, MB R3E 0V9, Canada; (M.K.); (B.B.); (F.M.); (J.R.); (P.K.); (S.A.); (S.M.B.); (P.K.); (B.L.); (S.L.); (J.W.G.)
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland
- Department of Biochemistry and Molecular Biology, University of Chicago, Chicago, IL 60637, USA
| | - Jakub Rosik
- Department of Human Anatomy and Cell Science, University of Manitoba College of Medicine, Winnipeg, MB R3E 0V9, Canada; (M.K.); (B.B.); (F.M.); (J.R.); (P.K.); (S.A.); (S.M.B.); (P.K.); (B.L.); (S.L.); (J.W.G.)
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland
- Department of Chemistry, University of Chicago, Chicago, IL 60637, USA
| | - Philip Kawalec
- Department of Human Anatomy and Cell Science, University of Manitoba College of Medicine, Winnipeg, MB R3E 0V9, Canada; (M.K.); (B.B.); (F.M.); (J.R.); (P.K.); (S.A.); (S.M.B.); (P.K.); (B.L.); (S.L.); (J.W.G.)
- Section of Neurosurgery, Department of Surgery, University of Manitoba, Health Sciences Centre, Winnipeg, MB R3A 1R9, Canada
| | - Saba Afifi
- Department of Human Anatomy and Cell Science, University of Manitoba College of Medicine, Winnipeg, MB R3E 0V9, Canada; (M.K.); (B.B.); (F.M.); (J.R.); (P.K.); (S.A.); (S.M.B.); (P.K.); (B.L.); (S.L.); (J.W.G.)
| | - Seyed Mohammadreza Bolandi
- Department of Human Anatomy and Cell Science, University of Manitoba College of Medicine, Winnipeg, MB R3E 0V9, Canada; (M.K.); (B.B.); (F.M.); (J.R.); (P.K.); (S.A.); (S.M.B.); (P.K.); (B.L.); (S.L.); (J.W.G.)
| | - Peiman Koleini
- Department of Human Anatomy and Cell Science, University of Manitoba College of Medicine, Winnipeg, MB R3E 0V9, Canada; (M.K.); (B.B.); (F.M.); (J.R.); (P.K.); (S.A.); (S.M.B.); (P.K.); (B.L.); (S.L.); (J.W.G.)
| | - Mohsen Taheri
- Genetics of Non-Communicable Disease Research Center, Zahedan University of Medical Sciences, Zahedan 9816743463, Iran;
| | - Tayyebeh Madrakian
- Department of Analytical Chemistry, Faculty of Chemistry, Bu-Ali Sina University, Hamedan 6517838695, Iran; (T.M.); (M.A.)
| | - Marek J. Łos
- Biotechnology Center, Silesian University of Technology, 8 Krzywousty St., 44-100 Gliwice, Poland;
| | - Benjamin Lindsey
- Department of Human Anatomy and Cell Science, University of Manitoba College of Medicine, Winnipeg, MB R3E 0V9, Canada; (M.K.); (B.B.); (F.M.); (J.R.); (P.K.); (S.A.); (S.M.B.); (P.K.); (B.L.); (S.L.); (J.W.G.)
| | - Nilufer Cakir
- Faculty of Engineering and Natural Sciences, Sabanci University, Tuzla, Istanbul 34956, Türkiye; (S.S.); (N.C.); (B.K.)
| | - Atefeh Zarepour
- Department of Biomedical Engineering, Faculty of Engineering and Natural Sciences, Istinye University, Sariyer, Istanbul 34396, Türkiye; (A.Z.); (A.Z.)
| | - Kiavash Hushmandi
- Department of Food Hygiene and Quality Control, Division of Epidemiology, Faculty of Veterinary Medicine, University of Tehran, Tehran 1419963114, Iran;
| | - Ali Fallah
- Integrated Manufacturing Technologies Research and Application Center, Sabanci University, Tuzla, Istanbul 34956, Türkiye;
| | - Bahattin Koc
- Faculty of Engineering and Natural Sciences, Sabanci University, Tuzla, Istanbul 34956, Türkiye; (S.S.); (N.C.); (B.K.)
- Integrated Manufacturing Technologies Research and Application Center, Sabanci University, Tuzla, Istanbul 34956, Türkiye;
- Sabanci University Nanotechnology Research and Application Center (SUNUM), Tuzla, Istanbul 34956, Türkiye
| | - Arezoo Khosravi
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, Istanbul Okan University, Istanbul 34959, Türkiye;
| | - Mazaher Ahmadi
- Department of Analytical Chemistry, Faculty of Chemistry, Bu-Ali Sina University, Hamedan 6517838695, Iran; (T.M.); (M.A.)
| | - Susan Logue
- Department of Human Anatomy and Cell Science, University of Manitoba College of Medicine, Winnipeg, MB R3E 0V9, Canada; (M.K.); (B.B.); (F.M.); (J.R.); (P.K.); (S.A.); (S.M.B.); (P.K.); (B.L.); (S.L.); (J.W.G.)
| | - Gorka Orive
- NanoBioCel Research Group, School of Pharmacy, University of the Basque Country (UPV/EHU), 01007 Vitoria-Gasteiz, Spain;
- University Institute for Regenerative Medicine and Oral Implantology–UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria-Gasteiz, Spain
- Bioaraba, NanoBioCel Research Group, 01006 Vitoria-Gasteiz, Spain
| | - Stevan Pecic
- Department of Chemistry and Biochemistry, California State University Fullerton, Fullerton, CA 92831, USA;
| | - Joseph W. Gordon
- Department of Human Anatomy and Cell Science, University of Manitoba College of Medicine, Winnipeg, MB R3E 0V9, Canada; (M.K.); (B.B.); (F.M.); (J.R.); (P.K.); (S.A.); (S.M.B.); (P.K.); (B.L.); (S.L.); (J.W.G.)
- College of Nursing, Rady Faculty of Health Science, University of Manitoba, Winnipeg, MB R3E 0V9, Canada
| | - Saeid Ghavami
- Department of Human Anatomy and Cell Science, University of Manitoba College of Medicine, Winnipeg, MB R3E 0V9, Canada; (M.K.); (B.B.); (F.M.); (J.R.); (P.K.); (S.A.); (S.M.B.); (P.K.); (B.L.); (S.L.); (J.W.G.)
- Biology of Breathing Theme, Children Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 0V9, Canada
- Autophagy Research Center, Shiraz University of Medical Sciences, Shiraz 7134845794, Iran
- Academy of Silesia, Faculty of Medicine, Rolna 43, 40-555 Katowice, Poland
- Research Institutes of Oncology and Hematology, Cancer Care Manitoba-University of Manitoba, Winnipeg, MB R3E 0V9, Canada
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8
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Arnold J, Vijayakumar N, Levy P. Advanced imaging and modeling in neonatal simulation. Semin Perinatol 2023; 47:151825. [PMID: 37940437 DOI: 10.1016/j.semperi.2023.151825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Advances in modeling and imaging have resulted in realistic tools that can be applied to education and training, and even direct patient care. These include point-of-care ultrasound (POCUS), 3-dimensional and digital anatomic modeling, and extended reality. These technologies have been used for the preparation of complex patient care through simulation-based clinical rehearsals, direct patient care such as the creation of patient devices and implants, and for simulation-based education and training for health professionals, patients and families. In this section, we discuss these emerging technologies and describe how they can be utilized to improve patient care.
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9
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Padovani P, Singh Y, Pass RH, Vasile CM, Nield LE, Baruteau AE. E-Health: A Game Changer in Fetal and Neonatal Cardiology? J Clin Med 2023; 12:6865. [PMID: 37959330 PMCID: PMC10650296 DOI: 10.3390/jcm12216865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Technological advancements have greatly impacted the healthcare industry, including the integration of e-health in pediatric cardiology. The use of telemedicine, mobile health applications, and electronic health records have demonstrated a significant potential to improve patient outcomes, reduce healthcare costs, and enhance the quality of care. Telemedicine provides a useful tool for remote clinics, follow-up visits, and monitoring for infants with congenital heart disease, while mobile health applications enhance patient and parents' education, medication compliance, and in some instances, remote monitoring of vital signs. Despite the benefits of e-health, there are potential limitations and challenges, such as issues related to availability, cost-effectiveness, data privacy and security, and the potential ethical, legal, and social implications of e-health interventions. In this review, we aim to highlight the current application and perspectives of e-health in the field of fetal and neonatal cardiology, including expert parents' opinions.
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Affiliation(s)
- Paul Padovani
- CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, 44000 Nantes, France;
- CHU Nantes, INSERM, CIC FEA 1413, Nantes Université, 44000 Nantes, France
| | - Yogen Singh
- Division of Neonatology, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Robert H. Pass
- Department of Pediatric Cardiology, Mount Sinai Kravis Children’s Hospital, New York, NY 10029, USA;
| | - Corina Maria Vasile
- Department of Pediatric and Adult Congenital Cardiology, University Hospital of Bordeaux, 33600 Bordeaux, France;
| | - Lynne E. Nield
- Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, ON M5S 1A1, Canada
- Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
| | - Alban-Elouen Baruteau
- CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, 44000 Nantes, France;
- CHU Nantes, INSERM, CIC FEA 1413, Nantes Université, 44000 Nantes, France
- CHU Nantes, CNRS, INSERM, L’Institut du Thorax, Nantes Université, 44000 Nantes, France
- INRAE, UMR 1280, PhAN, Nantes Université, 44000 Nantes, France
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Salavitabar A, Zampi JD, Thomas C, Zanaboni D, Les A, Lowery R, Yu S, Whiteside W. Augmented Reality Visualization of 3D Rotational Angiography in Congenital Heart Disease: A Comparative Study to Standard Computer Visualization. Pediatr Cardiol 2023:10.1007/s00246-023-03278-8. [PMID: 37725124 DOI: 10.1007/s00246-023-03278-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/12/2023] [Indexed: 09/21/2023]
Abstract
Augmented reality (AR) visualization of 3D rotational angiography (3DRA) provides 3D representations of cardiac structures with full visualization of the procedural environment. The purpose of this study was to evaluate the feasibility of converting 3DRAs of congenital heart disease patients to AR models, highlight the workflow for 3DRA optimization for AR visualization, and assess physicians' perceptions of their use. This single-center study prospectively evaluated 30 retrospectively-acquired 3DRAs that were converted to AR, compared to Computer Models (CM). Median patient age 6.5 years (0.24-38.8) and weight 20.6 kg (3.4-107.0). AR and CM quality were graded highly. RV pacing was associated with higher quality of both model types (p = 0.02). Visualization and identification of structures were graded as "very easy" in 81.1% (n = 73) and 67.8% (n = 61) of AR and CM, respectively. Fifty-nine (66%) grades 'Agreed' or 'Strongly Agreed' that AR models provided superior appreciation of 3D relationships; AR was found to be least beneficial in visualization of aortic arch obstruction. AR models were thought to be helpful in identifying pathology and assisting in interventional planning in 85 assessments (94.4%). There was significant potential seen in the opportunity for patient/family counseling and trainee/staff education with AR models. It is feasible to convert 3D models of 3DRAs into AR models, which are of similar image quality as compared to CM. AR models provided additional benefits to visualization of 3D relationships in most anatomies. Future directions include integration of interventional simulation, peri-procedural counseling of patients and families, and education of trainees and staff with AR models.
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Affiliation(s)
- Arash Salavitabar
- Cardiac Catheterization & Interventional Therapies, The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.
| | - Jeffrey D Zampi
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Courtney Thomas
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Dominic Zanaboni
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Andrea Les
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Ray Lowery
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Sunkyung Yu
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Wendy Whiteside
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
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Kirloskar KM, Haffner ZK, Abadeer A, Yosaitis J, Baker SB. The Innovation Press: A Primer on the Anatomy of Digital Design in Plastic Surgery. Ann Plast Surg 2023; 91:307-312. [PMID: 37489974 DOI: 10.1097/sap.0000000000003617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
ABSTRACT Three-dimensional (3D) printing continues to revolutionize the field of plastic surgery, allowing surgeons to adapt to the needs of individual patients and innovate, plan, or refine operative techniques. The utility of this manufacturing modality spans from surgical planning, medical education, and effective patient communication to tissue engineering and device prototyping and has valuable implications in every facet of plastic surgery. Three-dimensional printing is more accessible than ever to the surgical community, regardless of previous background in engineering or biotechnology. As such, the onus falls on the surgeon-innovator to have a functional understanding of the fundamental pipeline and processes in actualizing such innovation. We review the broad range of reported uses for 3D printing in plastic surgery, the process from conceptualization to production, and the considerations a physician must make when using 3D printing for clinical applications. We additionally discuss the role of computer-assisted design and manufacturing and virtual and augmented reality, as well as the ability to digitally modify devices using this software. Finally, a discussion of 3D printing logistics, printer types, and materials is included. With innovation and problem solving comprising key tenets of plastic surgery, 3D printing can be a vital tool in the surgeon's intellectual and digital arsenal to span the gap between concept and reality.
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Affiliation(s)
| | | | - Andrew Abadeer
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital
| | | | - Stephen B Baker
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital
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12
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Joseph FJ, Vanluchene HER, Goldberg J, Bervini D. 3D-Printed Head Model in Patient's Education for Micro-Neurosurgical Aneurysm Clipping Procedures. World Neurosurg 2023; 175:e1069-e1074. [PMID: 37087042 DOI: 10.1016/j.wneu.2023.04.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/13/2023] [Accepted: 04/15/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Computed tomography (CT), Magnetic resonance imaging (MRI), and 3D reconstruction from Digital Subtraction Angiography (DSA) are currently used in clinical consultations for patients diagnosed with intracranial aneurysms; however, they have limitations in helping patients understand the disease and possible treatments. This study investigates the use of a 3D-printed model of the patients' neurosurgical anatomy and vascular pathology as an educational tool in outpatient clinics. METHODS A 3D-printed model of a middle cerebral artery aneurysm was created for use during patient consultations to discuss microsurgical treatment of unruptured cerebral aneurysms. In total, 38 patients and 5 neurosurgeons were included in the study. After the consultation, the patients and neurosurgeons received a questionnaire to assess the effectiveness of the 3D-printed model as an educational tool. RESULTS The 3D model improved the patients' understanding of the diagnosis, the aneurysm's relationship to the parent artery; the treatment process as well as the risks if left untreated. The patients found the 3D model to be an interesting tool (97%). The neurosurgeons were satisfied with the 3D-printed model as a patient encounter tool, they found the model effective during consultation (87%) and better than the conventional education tools used during consultations (97%). CONCLUSIONS Using a 3D model improves communication, enhances the patient's understanding of the pathology and its treatment and potentially facilitates the informed consent process in patients undergoing intracranial aneurysm surgery.
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Affiliation(s)
- Fredrick J Joseph
- Image Guided Therapy, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
| | - Hanne E R Vanluchene
- Image Guided Therapy, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Johannes Goldberg
- Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland
| | - David Bervini
- Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland
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Asif A, Shearn AIU, Turner MS, Ordoñez MV, Sophocleous F, Mendez-Santos A, Valverde I, Angelini GD, Caputo M, Hamilton MCK, Biglino G. Assessment of post-infarct ventricular septal defects through 3D printing and statistical shape analysis. JOURNAL OF 3D PRINTING IN MEDICINE 2023; 7:3DP3. [PMID: 36911812 PMCID: PMC9990116 DOI: 10.2217/3dp-2022-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/12/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Post-infarct ventricular septal defect (PIVSD) is a serious complication of myocardial infarction. We evaluated 3D-printing models in PIVSD clinical assessment and the feasibility of statistical shape modeling for morphological analysis of the defects. METHODS Models (n = 15) reconstructed from computed tomography data were evaluated by clinicians (n = 8). Statistical shape modeling was performed on 3D meshes to calculate the mean morphological configuration of the defects. RESULTS Clinicians' evaluation highlighted the models' utility in displaying defects for interventional/surgical planning, education/training and device development. However, models lack dynamic representation. Morphological analysis was feasible and revealed oval-shaped (n = 12) and complex channel-like (n = 3) defects. CONCLUSION 3D-PIVSD models can complement imaging data for teaching and procedural planning. Statistical shape modeling is feasible in this scenario.
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Affiliation(s)
- Ashar Asif
- Bristol Medical School, University of Bristol, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
| | - Andrew IU Shearn
- Bristol Medical School, University of Bristol, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
- Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
| | - Mark S Turner
- Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
| | - Maria V Ordoñez
- Bristol Medical School, University of Bristol, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
- Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
| | - Froso Sophocleous
- Bristol Medical School, University of Bristol, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
- Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
| | - Ana Mendez-Santos
- Pediatric Cardiology Unit, Hospital Virgen del Rocio and Institute of Biomedicine of Seville (IBIS), Seville, E-41013, Spain
| | - Israel Valverde
- Pediatric Cardiology Unit, Hospital Virgen del Rocio and Institute of Biomedicine of Seville (IBIS), Seville, E-41013, Spain
- School of Biomedical Engineering and Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, SE1 7EH, UK
| | - Gianni D Angelini
- Bristol Medical School, University of Bristol, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
- Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
| | - Massimo Caputo
- Bristol Medical School, University of Bristol, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
- Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
| | - Mark CK Hamilton
- Department of Clinical Radiology, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
| | - Giovanni Biglino
- Bristol Medical School, University of Bristol, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
- Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK
- National Heart and Lung Institute, Guy Scadding Building, Imperial College London, London, SW3 6LY, UK
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14
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Patient-Specific 3D-Printed Models in Pediatric Congenital Heart Disease. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020319. [PMID: 36832448 PMCID: PMC9955978 DOI: 10.3390/children10020319] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/25/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
Three-dimensional (3D) printing technology has become increasingly used in the medical field, with reports demonstrating its superior advantages in both educational and clinical value when compared with standard image visualizations or current diagnostic approaches. Patient-specific or personalized 3D printed models serve as a valuable tool in cardiovascular disease because of the difficulty associated with comprehending cardiovascular anatomy and pathology on 2D flat screens. Additionally, the added value of using 3D-printed models is especially apparent in congenital heart disease (CHD), due to its wide spectrum of anomalies and its complexity. This review provides an overview of 3D-printed models in pediatric CHD, with a focus on educational value for medical students or graduates, clinical applications such as pre-operative planning and simulation of congenital heart surgical procedures, and communication between physicians and patients/parents of patients and between colleagues in the diagnosis and treatment of CHD. Limitations and perspectives on future research directions for the application of 3D printing technology into pediatric cardiology practice are highlighted.
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15
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Mao X, Wang Z. Research Progress of Three-Dimensional Bioprinting Artificial Cardiac Tissue. Tissue Eng Regen Med 2023; 20:1-9. [PMID: 36401767 PMCID: PMC9852375 DOI: 10.1007/s13770-022-00495-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/21/2022] Open
Abstract
Cardiovascular disease is one of the main diseases that endanger human life and health, and heart failure often occurs when the cardiovascular disease develops to the end-stage. Heart transplantation is the most effective treatment. However, there has always been a shortage of living heart organs. With the development of regenerative medicine, researchers have turned to bioprinting technology that can build tissues and organs in vitro. A large number of relevant literature on three-dimensional (3D) bioprinted hearts were searched and screened in Google Scholar. 3D bioprinting technology can accurately print biomaterials containing living cells into 3D functional living tissues, providing a feasible solution to the shortage of transplantable organs. As one of the most important organs in the human body, the research on 3D bioprinting of the heart has currently become a hot topic. This paper briefly overviews 3D bioprinting technology and the progress in bioprinting cardiac tissue. It is believed that in the future, bio-printed hearts will become a reality, making a new way of providing artificial organs for heart transplantation.
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Affiliation(s)
- Xin Mao
- School of Chemistry and Pharmaceutical Engineering, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, People's Republic of China
| | - Zhehui Wang
- School of Chemistry and Pharmaceutical Engineering, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, People's Republic of China.
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Giugno L, Formato GM, Chessa M, Votta E, Carminati M, Sturla F. Case report: Personalized transcatheter approach to mid-aortic syndrome by in vitro simulation on a 3-dimensional printed model. Front Cardiovasc Med 2023; 9:1076359. [PMID: 36704466 PMCID: PMC9871590 DOI: 10.3389/fcvm.2022.1076359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
An 8-year-old girl, diagnosed with mid-aortic syndrome (MAS) at the age of 2 months and under antihypertensive therapy, presented with severe systemic hypertension (>200/120 mmHg). Computed tomography (CT) examination revealed aortic aneurysm between severe stenoses at pre- and infra-renal segments, and occlusion of principal splanchnic arteries with peripheral collateral revascularization. Based on CT imaging, preoperative three-dimensional (3D) anatomy was reconstructed to assess aortic dimensions and a dedicated in vitro planning platform was designed to investigate the feasibility of a stenting procedure under fluoroscopic guidance. The in vitro system was designed to incorporate a translucent flexible 3D-printed patient-specific model filled with saline. A covered 8-zig 45-mm-long Cheatham-Platinum (CP) stent and a bare 8-zig, 34-mm-long CP stent were implanted with partial overlap to treat the stenoses (global peak-to-peak pressure gradient > 60 mmHg), excluding the aneurysm and avoiding risk of renal arteries occlusion. Percutaneous procedure was successfully performed with no residual pressure gradient and exactly replicating the strategy tested in vitro. Also, as investigated on the 3D-printed model, additional angioplasty was feasible across the frames of the stent to improve bilateral renal flow. Postoperative systemic pressure significantly reduced (130/70 mmHg) as well as dosage of antihypertensive therapy. This is the first report demonstrating the use of a 3D-printed model to effectively plan percutaneous intervention in a complex pediatric MAS case: taking full advantage of the combined use of a patient-specific 3D model and a dedicated in vitro platform, feasibility of the stenting procedure was successfully tested during pre-procedural assessment. Hence, use of patient-specific 3D-printed models and in vitro dedicated platforms is encouraged to assist pre-procedural planning and personalize treatment, thus enhancing intervention success.
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Affiliation(s)
- Luca Giugno
- Department of Pediatric and Adult Congenital Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Giovanni Maria Formato
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Massimo Chessa
- Department of Pediatric and Adult Congenital Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy,Facoltà di Medicina e Chirurgia, Vita Salute San Raffaele University, Milan, Italy,European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart: ERN GUARD-Heart, Amsterdam, Netherlands
| | - Emiliano Votta
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy,Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Mario Carminati
- Department of Pediatric and Adult Congenital Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Francesco Sturla
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy,Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy,*Correspondence: Francesco Sturla ✉
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Grab M, Hundertmark F, Thierfelder N, Fairchild M, Mela P, Hagl C, Grefen L. New perspectives in patient education for cardiac surgery using 3D-printing and virtual reality. Front Cardiovasc Med 2023; 10:1092007. [PMID: 36937915 PMCID: PMC10020687 DOI: 10.3389/fcvm.2023.1092007] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Background Preoperative anxiety in cardiac surgery can lead to prolonged hospital stays and negative postoperative outcomes. An improved patient education using 3D models may reduce preoperative anxiety and risks associated with it. Methods Patient education was performed with standardized paper-based methods (n = 34), 3D-printed models (n = 34) or virtual reality models (n = 31). Anxiety and procedural understanding were evaluated using questionnaires prior to and after the patient education. Additionally, time spent for the education and overall quality were evaluated among further basic characteristics (age, gender, medical expertise, previous non-cardiac surgery and previously informed patients). Included surgeries were coronary artery bypass graft, surgical aortic valve replacement and thoracic aortic aneurysm surgery. Results A significant reduction in anxiety measured by Visual Analog Scale was achieved after patient education with virtual reality models (5.00 to 4.32, Δ-0.68, p < 0.001). Procedural knowledge significantly increased for every group after the patient education while the visualization and satisfaction were best rated for patient education with virtual reality. Patients rated the quality of the patient education using both visualization methods individually [3D and virtual reality (VR) models] higher compared to the control group of conventional paper-sheets (control paper-sheets: 86.32 ± 11.89%, 3D: 94.12 ± 9.25%, p < 0.0095, VR: 92.90 ± 11.01%, p < 0.0412). Conclusion Routine patient education with additional 3D models can significantly improve the patients' satisfaction and reduce subjective preoperative anxiety effectively.
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Affiliation(s)
- Maximilian Grab
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
- Chair of Medical Materials and Implants, Technical University Munich, Munich, Germany
- Correspondence: Maximilian Grab
| | - Fabian Hundertmark
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
| | - Nikolaus Thierfelder
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
| | | | - Petra Mela
- Chair of Medical Materials and Implants, Technical University Munich, Munich, Germany
| | - Christian Hagl
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
| | - Linda Grefen
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
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Entezami P, Spurgas MP, O'Brien MW, Newman LC, Adamo MA. Utility of 3-dimensionally printed models for parent education in pediatric plagiocephaly. PEC INNOVATION 2022; 1:100077. [PMID: 37213734 PMCID: PMC10194339 DOI: 10.1016/j.pecinn.2022.100077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/11/2022] [Accepted: 08/18/2022] [Indexed: 05/23/2023]
Abstract
Objectives Demonstrate the benefits of using 3D printed skull models when counseling families regarding disorders of the cranial vault (namely plagiocephaly and craniosynostosis), as traditional imaging review and discussion is often insufficient. Methods 3D printed skull models of a patient with plagiocephaly were used during clinic appointments to aid in the counseling of parents. Surveys were distributed following the appointment to evaluate the utility of these models during the discussion. Results Fifty surveys were distributed (with a 98% response rate). 3D models were both empirically and anecdotally helpful for parents in understanding their child's diagnosis. Conclusion Advances in 3D printing technology and software have made producing models more accessible. Incorporating physical, disorder-specific models into our discussions has led to improvements in our ability to communicate with our patients and their families. Innovation Disorders of the cranial can be challenging to describe to the parents and guardians of affected children; using 3D printed models is a useful adjunct in patient-centered discussions. The subject response to the use of these emerging technologies in this setting suggests a major role for 3D models in patient education and counseling for cranial vault disorders.
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Affiliation(s)
- Pouya Entezami
- Corresponding author at: Albany Medical Center, 47 New Scotland Ave MC-10, Albany, NY 12208, , United States of America.
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Mogali SR, Chandrasekaran R, Radzi S, Peh ZK, Tan GJS, Rajalingam P, Yee Yeong W. Investigating the effectiveness of three-dimensionally printed anatomical models compared with plastinated human specimens in learning cardiac and neck anatomy: A randomized crossover study. ANATOMICAL SCIENCES EDUCATION 2022; 15:1007-1017. [PMID: 34363315 DOI: 10.1002/ase.2128] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
Three-dimensional printing (3DP) technology has been increasingly applied in health profession education. Yet, 3DP anatomical models compared with the plastinated specimens as learning scaffolds are unclear. A randomized-controlled crossover study was used to evaluate the objective outcomes of 3DP models compared with the plastinated specimens through an introductory lecture and team study for learning relatively simple (cardiac) and complex (neck) anatomies. Given the novel multimaterial and multicolored 3DP models are replicas of the plastinated specimens, it is hypothesized that 3DP models have the same educational benefits to plastinated specimens. This study was conducted in two phases in which participants were randomly assigned to 3DP (n = 31) and plastinated cardiac groups (n = 32) in the first phase, whereas same groups (3DP, n = 15; plastinated, n = 18) used switched materials in the second phase for learning neck anatomy. The pretest, educational activities and posttest were conducted for each phase. Miller's framework was used to assess the cognitive outcomes. There was a significant improvement in students' baseline knowledge by 29.7% and 31.3% for Phase 1; 31.7% and 31.3% for Phase 2 plastinated and 3DP models. Posttest scores for cardiac (plastinated, 3DP mean ± SD: 57.0 ± 13.3 and 60.8 ± 13.6, P = 0.27) and neck (70.3 ± 15.6 and 68.3 ± 9.9, P = 0.68) phases showed no significant difference. In addition, no difference observed when cognitive domains compared for both cases. These results reflect that introductory lecture plus either the plastinated or 3DP modes were effective for learning cardiac and neck anatomy.
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Affiliation(s)
| | - Ramya Chandrasekaran
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Shairah Radzi
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Zhen Kai Peh
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Gerald Jit Shen Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
| | - Preman Rajalingam
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Wai Yee Yeong
- Singapore Centre for 3D Printing, School of Mechanical and Aerospace Engineering, Nanyang Technological University Singapore, Singapore
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Lau I, Gupta A, Ihdayhid A, Sun Z. Clinical Applications of Mixed Reality and 3D Printing in Congenital Heart Disease. Biomolecules 2022; 12:1548. [PMID: 36358899 PMCID: PMC9687840 DOI: 10.3390/biom12111548] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/19/2022] [Accepted: 10/22/2022] [Indexed: 04/05/2024] Open
Abstract
Understanding the anatomical features and generation of realistic three-dimensional (3D) visualization of congenital heart disease (CHD) is always challenging due to the complexity and wide spectrum of CHD. Emerging technologies, including 3D printing and mixed reality (MR), have the potential to overcome these limitations based on 2D and 3D reconstructions of the standard DICOM (Digital Imaging and Communications in Medicine) images. However, very little research has been conducted with regard to the clinical value of these two novel technologies in CHD. This study aims to investigate the usefulness and clinical value of MR and 3D printing in assisting diagnosis, medical education, pre-operative planning, and intraoperative guidance of CHD surgeries through evaluations from a group of cardiac specialists and physicians. Two cardiac computed tomography angiography scans that demonstrate CHD of different complexities (atrial septal defect and double outlet right ventricle) were selected and converted into 3D-printed heart models (3DPHM) and MR models. Thirty-four cardiac specialists and physicians were recruited. The results showed that the MR models were ranked as the best modality amongst the three, and were significantly better than DICOM images in demonstrating complex CHD lesions (mean difference (MD) = 0.76, p = 0.01), in enhancing depth perception (MD = 1.09, p = 0.00), in portraying spatial relationship between cardiac structures (MD = 1.15, p = 0.00), as a learning tool of the pathology (MD = 0.91, p = 0.00), and in facilitating pre-operative planning (MD = 0.87, p = 0.02). The 3DPHM were ranked as the best modality and significantly better than DICOM images in facilitating communication with patients (MD = 0.99, p = 0.00). In conclusion, both MR models and 3DPHM have their own strengths in different aspects, and they are superior to standard DICOM images in the visualization and management of CHD.
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Affiliation(s)
- Ivan Lau
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6845, Australia
| | - Ashu Gupta
- Department of Medical Imaging, Fiona Stanley Hospital, Perth, WA 6150, Australia
| | - Abdul Ihdayhid
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia
- Department of Cardiology, Fiona Stanley Hospital, Perth, WA 6150, Australia
| | - Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6845, Australia
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Sun Z, Wee C. 3D Printed Models in Cardiovascular Disease: An Exciting Future to Deliver Personalized Medicine. MICROMACHINES 2022; 13:1575. [PMID: 36295929 PMCID: PMC9610217 DOI: 10.3390/mi13101575] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
3D printing has shown great promise in medical applications with increased reports in the literature. Patient-specific 3D printed heart and vascular models replicate normal anatomy and pathology with high accuracy and demonstrate superior advantages over the standard image visualizations for improving understanding of complex cardiovascular structures, providing guidance for surgical planning and simulation of interventional procedures, as well as enhancing doctor-to-patient communication. 3D printed models can also be used to optimize CT scanning protocols for radiation dose reduction. This review article provides an overview of the current status of using 3D printing technology in cardiovascular disease. Limitations and barriers to applying 3D printing in clinical practice are emphasized while future directions are highlighted.
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Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth 6845, Australia
| | - Cleo Wee
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth 6845, Australia
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22
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Grosshauser M, Ohletz T, Oesch V, Muller CO. Tips and Tricks—3 Use Cases of Interdisciplinary Knowledge Transfer in Minimally Invasive Pediatric Surgery. CHILDREN 2022; 9:children9091270. [PMID: 36138579 PMCID: PMC9497707 DOI: 10.3390/children9091270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 11/16/2022]
Abstract
In the pediatric surgical environment, we can enrich our knowledge and improve our skills through interdisciplinary knowledge transfer in exchange with other surgical or even non-surgical disciplines. To demonstrate this, we present in this article three patient cases of method transfer enabling new techniques in minimally invasive pediatric surgery. 1. The somewhat modified application of the AeroStat rigid tip laparoscopic cholangiography catheter during the single-step laparoscopic cholecystectomy facilitates the safe intraoperative cholangiography with common bile duct flushing. 2. A magnetic rod is used during laparoscopic enterotomy to locate and retrieve ingested magnets. 3. Using a patient-specific MRI 3D model representing a syndromic high anorectal malformation improves surgical planning and parental education.
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Affiliation(s)
- Mareike Grosshauser
- Department of Paediatric Surgery, Cantonal Hospital Aarau, Tellstrasse 25, 5000 Aarau, Switzerland
- Correspondence: ; Tel.: +41-62-838-2767
| | - Tim Ohletz
- Department of Radiology and 3D Lab, Cantonal Hospital Aarau, Tellstrasse 25, 5000 Aarau, Switzerland
| | - Valérie Oesch
- Department of Paediatric Surgery, Cantonal Hospital Aarau, Tellstrasse 25, 5000 Aarau, Switzerland
| | - Cécile Olivia Muller
- Department of Paediatric Surgery, Cantonal Hospital Aarau, Tellstrasse 25, 5000 Aarau, Switzerland
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Spanaki A, Kabir S, Stephenson N, van Poppel MPM, Benetti V, Simpson J. 3D Approaches in Complex CHD: Where Are We? Funny Printing and Beautiful Images, or a Useful Tool? J Cardiovasc Dev Dis 2022; 9:269. [PMID: 36005432 PMCID: PMC9410138 DOI: 10.3390/jcdd9080269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
Echocardiography, CT and MRI have a crucial role in the management of congenital heart disease (CHD) patients. All of these modalities can be presented in a 2D or a 3D rendered format. The aim of this paper is to review the key advantages and potential limitations, as well as the future challenges of a 3D approach in each imaging modality. The focus of this review is on anatomic rather than functional assessment. Conventional 2D echocardiography presents limitations when imaging complex lesions, whereas 3D imaging depicts the anatomy in all dimensions. CT and MRI can visualise extracardiac vasculature and guide complex biventricular repair. Three-dimensional printed models can be used in depicting complex intracardiac relationships and defining the surgical strategy in specific lesions. Extended reality imaging retained dynamic cardiac motion holds great potential for planning surgical and catheter procedures. Overall, the use of 3D imaging has resulted in a better understanding of anatomy, with a direct impact on the surgical and catheter approach, particularly in more complex cases.
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Affiliation(s)
- Adriani Spanaki
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London SE1 7EH, UK
| | - Saleha Kabir
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London SE1 7EH, UK
| | - Natasha Stephenson
- School of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, UK
| | - Milou P. M. van Poppel
- School of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, UK
| | - Valentina Benetti
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London SE1 7EH, UK
| | - John Simpson
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London SE1 7EH, UK
- School of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, UK
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24
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Tejo-Otero A, Valls-Esteve A, Fenollosa-Artés F, Siles-Hinojosa A, Nafria B, Ayats M, Buj-Corral I, Otero MC, Rubio-Palau J, Munuera J, Krauel L. Patient comprehension of oncologic surgical procedures using 3D printed surgical planning prototypes. ANNALS OF 3D PRINTED MEDICINE 2022. [DOI: 10.1016/j.stlm.2022.100068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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25
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Bernhard B, Illi J, Gloeckler M, Pilgrim T, Praz F, Windecker S, Haeberlin A, Gräni C. Imaging-Based, Patient-Specific Three-Dimensional Printing to Plan, Train, and Guide Cardiovascular Interventions: A Systematic Review and Meta-Analysis. Heart Lung Circ 2022; 31:1203-1218. [PMID: 35680498 DOI: 10.1016/j.hlc.2022.04.052] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/14/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND To tailor cardiovascular interventions, the use of three-dimensional (3D), patient-specific phantoms (3DPSP) encompasses patient education, training, simulation, procedure planning, and outcome-prediction. AIM This systematic review and meta-analysis aims to investigate the current and future perspective of 3D printing for cardiovascular interventions. METHODS We systematically screened articles on Medline and EMBASE reporting the prospective use of 3DPSP in cardiovascular interventions by using combined search terms. Studies that compared intervention time depending on 3DPSP utilisation were included into a meta-analysis. RESULTS We identified 107 studies that prospectively investigated a total of 814 3DPSP in cardiovascular interventions. Most common settings were congenital heart disease (CHD) (38 articles, 6 comparative studies), left atrial appendage (LAA) occlusion (11 articles, 5 comparative, 1 randomised controlled trial [RCT]), and aortic disease (10 articles). All authors described 3DPSP as helpful in assessing complex anatomic conditions, whereas poor tissue mimicry and the non-consideration of physiological properties were cited as limitations. Compared to controls, meta-analysis of six studies showed a significant reduction of intervention time in LAA occlusion (n=3 studies), and surgery due to CHD (n=3) if 3DPSPs were used (Cohen's d=0.54; 95% confidence interval, 0.13 to 0.95; p=0.001), however heterogeneity across studies should be taken into account. CONCLUSIONS 3DPSP are helpful to plan, train, and guide interventions in patients with complex cardiovascular anatomy. Benefits for patients include reduced intervention time with the potential for lower radiation exposure and shorter mechanical ventilation times. More evidence and RCTs including clinical endpoints are needed to warrant adoption of 3DPSP into routine clinical practice.
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Affiliation(s)
- Benedikt Bernhard
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Joël Illi
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Swiss MedTech Center, Switzerland Innovation Park Biel/Bienne AG, Switzerland
| | - Martin Gloeckler
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas Pilgrim
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fabien Praz
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stephan Windecker
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Haeberlin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Translational Imaging Center, Sitem Center, University of Bern, Switzerland
| | - Christoph Gräni
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Translational Imaging Center, Sitem Center, University of Bern, Switzerland.
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26
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Tan L, Wang Z, Jiang H, Han B, Tang J, Kang C, Zhang N, Xu Y. Full color 3D printing of anatomical models. Clin Anat 2022; 35:598-608. [PMID: 35384062 DOI: 10.1002/ca.23875] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/20/2022] [Accepted: 03/31/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION We propose an effective method for manufacturing human anatomical specimens in response to the shortage of cadaver specimens and the poor simulation results of anatomical specimen substitutes. METHODS Digital human data with high precision were used to create digital models and corresponding mapped textures. Different materials were chosen to print the digital models with full-color and multimaterial 3D-printing technology on the basis of the histological characteristics of the anatomical structures. Anatomy experts and surgeons were then invited to compare the 3D printed models with authentic anatomical specimens in terms of morphological appearance, anatomical detail, and textural properties. RESULTS The skull, brain, hand muscles, blood vessels and nerves of the hand, and the deep structure of the head and face were printed. The skull model used hard material, and the brain and hand muscles models used flexible and hard materials combined. The blood vessels, nerves of the hand, and the superficial and deep structure of the head and face used transparent materials, revealing the small vessels and nerves in the interior. In all the models there were no significant differences from anatomical specimens in morphological appearance and anatomical detail. They also affected vision and touch in the same way as authentic specimens in the textural properties of color, roughness, smoothness, and fineness. CONCLUSION Full-color and multi-material 3D printed anatomical models have the same visual and tactile properties as anatomical specimens and could serve to complement or supplement them in anatomy teaching to compensate for the shortage of cadavers. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Liwen Tan
- Shandong Digihuman Technology Co., Inc. JiNan, 250100, China
| | - Zengtao Wang
- Hand and Foot Surgery, Shandong Provincial Hospital affiliated to Shandong University, JiNan, China
| | - Hongxin Jiang
- Department of Radiology, the Gucheng Hospital, Hebei, China
| | - Bing Han
- Shandong Digihuman Technology Co., Inc. JiNan, 250100, China
| | - Jing Tang
- Shandong Digihuman Technology Co., Inc. JiNan, 250100, China
| | - Chengfeng Kang
- Shandong Digihuman Technology Co., Inc. JiNan, 250100, China
| | - Na Zhang
- Shandong Digihuman Technology Co., Inc. JiNan, 250100, China
| | - Yifa Xu
- Shandong Digihuman Technology Co., Inc. JiNan, 250100, China
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Cornejo J, Cornejo-Aguilar JA, Vargas M, Helguero CG, Milanezi de Andrade R, Torres-Montoya S, Asensio-Salazar J, Rivero Calle A, Martínez Santos J, Damon A, Quiñones-Hinojosa A, Quintero-Consuegra MD, Umaña JP, Gallo-Bernal S, Briceño M, Tripodi P, Sebastian R, Perales-Villarroel P, De la Cruz-Ku G, Mckenzie T, Arruarana VS, Ji J, Zuluaga L, Haehn DA, Paoli A, Villa JC, Martinez R, Gonzalez C, Grossmann RJ, Escalona G, Cinelli I, Russomano T. Anatomical Engineering and 3D Printing for Surgery and Medical Devices: International Review and Future Exponential Innovations. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6797745. [PMID: 35372574 PMCID: PMC8970887 DOI: 10.1155/2022/6797745] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 12/26/2022]
Abstract
Three-dimensional printing (3DP) has recently gained importance in the medical industry, especially in surgical specialties. It uses different techniques and materials based on patients' needs, which allows bioprofessionals to design and develop unique pieces using medical imaging provided by computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, the Department of Biology and Medicine and the Department of Physics and Engineering, at the Bioastronautics and Space Mechatronics Research Group, have managed and supervised an international cooperation study, in order to present a general review of the innovative surgical applications, focused on anatomical systems, such as the nervous and craniofacial system, cardiovascular system, digestive system, genitourinary system, and musculoskeletal system. Finally, the integration with augmented, mixed, virtual reality is analyzed to show the advantages of personalized treatments, taking into account the improvements for preoperative, intraoperative planning, and medical training. Also, this article explores the creation of devices and tools for space surgery to get better outcomes under changing gravity conditions.
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Affiliation(s)
- José Cornejo
- Facultad de Ingeniería, Universidad San Ignacio de Loyola, La Molina, Lima 15024, Peru
- Department of Medicine and Biology & Department of Physics and Engineering, Bioastronautics and Space Mechatronics Research Group, Lima 15024, Peru
| | | | | | | | - Rafhael Milanezi de Andrade
- Robotics and Biomechanics Laboratory, Department of Mechanical Engineering, Universidade Federal do Espírito Santo, Brazil
| | | | | | - Alvaro Rivero Calle
- Department of Oral and Maxillofacial Surgery, Hospital 12 de Octubre, Madrid, Spain
| | - Jaime Martínez Santos
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Aaron Damon
- Department of Neurosurgery, Mayo Clinic, FL, USA
| | | | | | - Juan Pablo Umaña
- Cardiovascular Surgery, Instituto de Cardiología-Fundación Cardioinfantil, Universidad del Rosario, Bogotá DC, Colombia
| | | | - Manolo Briceño
- Villamedic Group, Lima, Peru
- Clínica Internacional, Lima, Peru
| | | | - Raul Sebastian
- Department of Surgery, Northwest Hospital, Randallstown, MD, USA
| | | | - Gabriel De la Cruz-Ku
- Universidad Científica del Sur, Lima, Peru
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Jiakai Ji
- Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY, USA
| | - Laura Zuluaga
- Department of Urology, Fundación Santa Fe de Bogotá, Colombia
| | | | - Albit Paoli
- Howard University Hospital, Washington, DC, USA
| | | | | | - Cristians Gonzalez
- Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut of Image-Guided Surgery (IHU-Strasbourg), Strasbourg, France
| | | | - Gabriel Escalona
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Santiago, Chile
| | - Ilaria Cinelli
- Aerospace Human Factors Association, Aerospace Medical Association, VA, USA
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3D Printing Surgical Phantoms and their Role in the Visualization of Medical Procedures. ANNALS OF 3D PRINTED MEDICINE 2022. [DOI: 10.1016/j.stlm.2022.100057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Traynor G, Shearn AIU, Milano EG, Ordonez MV, Velasco Forte MN, Caputo M, Schievano S, Mustard H, Wray J, Biglino G. The use of 3D-printed models in patient communication: a scoping review. JOURNAL OF 3D PRINTING IN MEDICINE 2022; 6:13-23. [PMID: 35211330 PMCID: PMC8852361 DOI: 10.2217/3dp-2021-0021] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 12/07/2021] [Indexed: 11/21/2022]
Abstract
3D models have been used as an asset in many clinical applications and a variety of disciplines, and yet the available literature studying the use of 3D models in communication is limited. This scoping review has been conducted to draw conclusions on the current evidence and learn from previous studies, using this knowledge to inform future work. Our search strategy revealed 269 papers, 19 of which were selected for final inclusion and analysis. When assessing the use of 3D models in doctor-patient communication, there is a need for larger studies and studies including a long-term follow up. Furthermore, there are forms of communication that are yet to be researched and provide a niche that may be beneficial to explore.
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Affiliation(s)
- Gemma Traynor
- Bristol Medical School, University of Bristol, Bristol, BS8 1UD, UK
| | - Andrew IU Shearn
- Bristol Medical School, University of Bristol, Bristol, BS8 1UD, UK
| | - Elena G Milano
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, WC1N 3JH, UK
| | | | | | - Massimo Caputo
- Bristol Medical School, University of Bristol, Bristol, BS8 1UD, UK
- University Hospitals Bristol & Weston, NHS Foundation Trust, Bristol, BS1 3NU, UK
| | - Silvia Schievano
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, WC1N 3JH, UK
- Institute of Cardiovascular Science, University College London, London, WC1E 6DD, UK
| | - Hannah Mustard
- University Hospitals Bristol & Weston, NHS Foundation Trust, Bristol, BS1 3NU, UK
| | - Jo Wray
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, WC1N 3JH, UK
| | - Giovanni Biglino
- Bristol Medical School, University of Bristol, Bristol, BS8 1UD, UK
- National Heart & Lung Institute, Imperial College London, London, SW3 6LY, UK
- Author for correspondence: Tel.: +44 117 342 3287;
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Karsenty C, Hadeed K, Djeddai C, Lateyron J, Guitarte A, Vincent R, DeBarros N, Combes N, Briot J, Dulac Y, Yrondi A, Acar P. Impact of 3D-printed models in meetings with parents of children undergoing interventional cardiac catheterisation. Front Pediatr 2022; 10:947340. [PMID: 36699296 PMCID: PMC9869040 DOI: 10.3389/fped.2022.947340] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 12/06/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Paediatric interventional catheterisation has consistently improved in recent decades, with often highly successful outcomes. However, progress is still required in terms of the information delivered to parents and how parental anxiety is managed. AIM To investigate the impact of cardiac printed models on improving parental understanding and alleviating anxiety before interventional catheterisation. METHODS The parents of children undergoing interventional cardiac catheterisation were prospectively enrolled in the study. A questionnaire highlighting knowledge and understanding of the condition and cardiac catheterisation per se was scored on a scale of 1-30. The State-Trait Anxiety Inventory (STAI), which generates current anxiety scores, was also used before and after the pre-catheterisation meeting. The "printing group" received an explanation of catheterisation using the device and a three-dimensional (3D) model, while the "control group" received an explanation using only the device and a manual drawing. RESULTS In total, 76 parents of 50 children were randomly assigned to a "control group" (n = 38) or "printing group" (n = 38). The groups were comparable at baseline. The level of understanding and knowledge improved after the "control group" and "printing group" meetings (+5.5±0.8 and +10.2±0.8; p < 0.0001 and p < 0.0001, respectively). A greater improvement was documented in the "printing group" compared to the "control group" (p < 0.0001). The STAI score also improved after the explanation was given to both groups (-1.8±0.6 and -5.6±1.0; p < 0.0001 and p < 0.0001). The greatest improvement was noted in the "printing group" (p = 0.0025). Most of the parents (35/38 from the "printing group") found the models to be extremely useful. CONCLUSION 3D-printed models improve parental knowledge and understanding of paediatric cardiac catheterisation, thereby reducing anxiety levels.
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Affiliation(s)
- Clément Karsenty
- Department of Paediatric Cardiology, University Hospital, Toulouse, France.,Institut Des Maladies Métaboliques Et Cardiovasculaires (Institute of Metabolic and Cardiovascular Diseases), University of Toulouse, INSERM U1048, I2MC, 1, Avenue Jean Poulhès-BP84225, Toulouse, France.,Department of Cardiology, Clinique Pasteur (Pasteur Clinic), Toulouse, France
| | - Khaled Hadeed
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Camelia Djeddai
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Julie Lateyron
- Department of Psychiatry, Marchant Hospital, Toulouse, France
| | - Aitor Guitarte
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Remi Vincent
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Nathalie DeBarros
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Nicolas Combes
- Department of Paediatric Cardiology, University Hospital, Toulouse, France.,Department of Cardiology, Clinique Pasteur (Pasteur Clinic), Toulouse, France
| | - Jerome Briot
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Yves Dulac
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Antoine Yrondi
- Department of Psychiatry, University Hospital, Toulouse, France
| | - Philippe Acar
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
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Zablah JE, Rodriguez SA, Lorenz A, Morgan GJ. Cardiac catheterization laboratory and the role in effective patient education: A model approach. PROGRESS IN PEDIATRIC CARDIOLOGY 2021. [DOI: 10.1016/j.ppedcard.2021.101396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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32
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Sun Z, Ng CKC, Wong YH, Yeong CH. 3D-Printed Coronary Plaques to Simulate High Calcification in the Coronary Arteries for Investigation of Blooming Artifacts. Biomolecules 2021; 11:biom11091307. [PMID: 34572520 PMCID: PMC8468360 DOI: 10.3390/biom11091307] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022] Open
Abstract
The diagnostic value of coronary computed tomography angiography (CCTA) is significantly affected by high calcification in the coronary arteries owing to blooming artifacts limiting its accuracy in assessing the calcified plaques. This study aimed to simulate highly calcified plaques in 3D-printed coronary models. A combination of silicone + 32.8% calcium carbonate was found to produce 800 HU, representing extensive calcification. Six patient-specific coronary artery models were printed using the photosensitive polyurethane resin and a total of 22 calcified plaques with diameters ranging from 1 to 4 mm were inserted into different segments of these 3D-printed coronary models. The coronary models were scanned on a 192-slice CT scanner with 70 kV, pitch of 1.4, and slice thickness of 1 mm. Plaque attenuation was measured between 1100 and 1400 HU. Both maximum-intensity projection (MIP) and volume rendering (VR) images (wide and narrow window widths) were generated for measuring the diameters of these calcified plaques. An overestimation of plaque diameters was noticed on both MIP and VR images, with measurements on the MIP images close to those of the actual plaque sizes (<10% deviation), and a large measurement discrepancy observed on the VR images (up to 50% overestimation). This study proves the feasibility of simulating extensive calcification in coronary arteries using a 3D printing technique to develop calcified plaques and generate 3D-printed coronary models.
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Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6845, Australia;
- Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia
- Correspondence: ; Tel.: +61-8-9266-7509; Fax: +61-8-9266-2377
| | - Curtise Kin Cheung Ng
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6845, Australia;
- Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia
| | - Yin How Wong
- Faculty of Health & Medical Sciences, School of Medicine, Taylor’s University, No. 1, Jalan Taylor’s, Subang Jaya 47500, Malaysia; (Y.H.W.); (C.H.Y.)
| | - Chai Hong Yeong
- Faculty of Health & Medical Sciences, School of Medicine, Taylor’s University, No. 1, Jalan Taylor’s, Subang Jaya 47500, Malaysia; (Y.H.W.); (C.H.Y.)
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Awori J, Friedman SD, Chan T, Howard C, Seslar S, Soriano BD, Buddhe S. 3D models improve understanding of congenital heart disease. 3D Print Med 2021; 7:26. [PMID: 34471999 PMCID: PMC8411549 DOI: 10.1186/s41205-021-00115-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/27/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction Understanding congenital heart disease (CHD) is vital for medical personnel and parents of affected children. While traditional 2D schematics serve as the typical approach used, several studies have shown these models to be limiting in understanding complex structures. Recent world-emphasis has shifted to 3D printed models as a complement to 2D imaging to bridge knowledge and create new opportunities for experiential learning. We sought to systematically compare 3D digital and physical models for medical personnel and parent education compared to traditional methods. Methods 3D printed and digital models were made out of MRI and CT data for 20 common CHD. Fellows and nurse practitioners used these models to explore intra-cardiac pathologies following traditional teaching. The models were also used for parent education in outpatient settings after traditional education. The participants were then asked to fill out a Likert scale questionnaire to assess their understanding and satisfaction with different teaching techniques. These ratings were compared using paired t-tests and Pearson’s correlation. Results Twenty-five medical personnel (18 fellows; 2 nurses; 4 nurse practitioners and one attending) and twenty parents participated in the study. The diagnosis varied from simple mitral valve pathology to complex single ventricle palliation. Parent and medical personnel perceived understanding with digital models was significantly higher than traditional (p = 0.01). Subjects also felt that physical models were overall more useful than digital ones (p = 0.001). Physicians using models for parent education also perceived the models to be useful, not significantly impacting their clinical workflow. Conclusions 3D models, both digital and printed, enhance medical personnel and parental perceived understanding of CHD. Supplementary Information The online version contains supplementary material available at 10.1186/s41205-021-00115-7.
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Affiliation(s)
- Jonathan Awori
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA.
| | - Seth D Friedman
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA
| | - Titus Chan
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA
| | - Christopher Howard
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA
| | - Steve Seslar
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA
| | - Brian D Soriano
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA
| | - Sujatha Buddhe
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA
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Hopfner C, Jakob A, Tengler A, Grab M, Thierfelder N, Brunner B, Thierij A, Haas NA. Design and 3D printing of variant pediatric heart models for training based on a single patient scan. 3D Print Med 2021; 7:25. [PMID: 34463879 PMCID: PMC8406574 DOI: 10.1186/s41205-021-00116-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/15/2021] [Indexed: 11/24/2022] Open
Abstract
Background 3D printed models of pediatric hearts with congenital heart disease have been proven helpful in simulation training of diagnostic and interventional catheterization. However, anatomically accurate 3D printed models are traditionally based on real scans of clinical patients requiring specific imaging techniques, i.e., CT or MRI. In small children both imaging technologies are rare as minimization of radiation and sedation is key. 3D sonography does not (yet) allow adequate imaging of the entire heart for 3D printing. Therefore, an alternative solution to create variant 3D printed heart models for teaching and hands-on training has been established. Methods In this study different methods utilizing image processing and computer aided design software have been established to overcome this shortage and to allow unlimited variations of 3D heart models based on single patient scans. Patient-specific models based on a CT or MRI image stack were digitally modified to alter the original shape and structure of the heart. Thereby, 3D hearts showing various pathologies were created. Training models were adapted to training level and aims of hands-on workshops, particularly for interventional cardiology. Results By changing the shape and structure of the original anatomy, various training models were created of which four examples are presented in this paper: 1. Design of perimembranous and muscular ventricular septal defect on a heart model with patent ductus arteriosus, 2. Series of heart models with atrial septal defect showing the long-term hemodynamic effect of the congenital heart defect on the right atrial and ventricular wall, 3. Implementation of simplified heart valves and addition of the myocardium to a right heart model with pulmonary valve stenosis, 4. Integration of a constructed 3D model of the aortic valve into a pulsatile left heart model with coarctation of the aorta. All presented models have been successfully utilized and evaluated in teaching or hands-on training courses. Conclusions It has been demonstrated that non-patient-specific anatomical variants can be created by modifying existing patient-specific 3D heart models. This way, a range of pathologies can be modeled based on a single CT or MRI dataset. Benefits of designed 3D models for education and training purposes have been successfully applied in pediatric cardiology but can potentially be transferred to simulation training in other medical fields as well.
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Affiliation(s)
- Carina Hopfner
- Department of Pediatric Cardiology and Pediatric Intensive Care, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany.
| | - Andre Jakob
- Department of Pediatric Cardiology and Pediatric Intensive Care, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Anja Tengler
- Department of Pediatric Cardiology and Pediatric Intensive Care, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Maximilian Grab
- Department of Cardiac Surgery, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Nikolaus Thierfelder
- Department of Cardiac Surgery, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Barbara Brunner
- Department of Pediatric Cardiology and Pediatric Intensive Care, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Alisa Thierij
- Department of Pediatric Cardiology and Pediatric Intensive Care, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Nikolaus A Haas
- Department of Pediatric Cardiology and Pediatric Intensive Care, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
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Deng X, He S, Huang P, Luo J, Yang G, Zhou B, Xiao Y. A three-dimensional printed model in preoperative consent for ventricular septal defect repair. J Cardiothorac Surg 2021; 16:229. [PMID: 34380540 PMCID: PMC8359557 DOI: 10.1186/s13019-021-01604-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 07/29/2021] [Indexed: 11/28/2022] Open
Abstract
Background The 3D printing technology in congenital cardiac surgery has been widely utilized to improve patients’ understanding of their disease. However, there has been no randomized controlled study on its usefulness in surgical consent for congenital heart disease repair. Methods A randomized controlled study was performed during consent process in which guardians of candidates for ventricular septal defect repair were given detailed explanation of the anatomy, indication for surgery and potential complication and risks using 3D print ventricular septal defect model (n = 20) versus a conventional 2D diagram (n = 20). A questionnaire was finished by each guardian of the patients. Data collected from questionnaires as well as medical records were statistically analyzed. Results Statistically significant improvements in ratings of understanding of ventricular septal defect anatomy (p = 0.02), and of the surgical procedure and potential complications (p = 0.02) were noted in the group that used the 3D model, though there was no difference in overall ratings of the consent process (p = 0.09). There was no difference in questionnaire score between subjects with different education levels. The clinical outcomes, as represented by the duration of intensive care unit stay, intubation duration was comparable between the two groups. Conclusions The results indicated that it was an effective tool which may be used to consent for congenital heart surgery. Different education levels do not affect guardians’ understanding in consent. The impact of 3D printing used in this scenario on long term outcomes remains to be defined.
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Affiliation(s)
- Xicheng Deng
- Heart Center, Hunan Children's Hospital, No. 86 Ziyuan Road, Changsha, 410007, China.
| | - Siping He
- Department of Radiology, Hunan Children's Hospital, Changsha, 410007, China
| | - Peng Huang
- Heart Center, Hunan Children's Hospital, No. 86 Ziyuan Road, Changsha, 410007, China
| | - Jinwen Luo
- Heart Center, Hunan Children's Hospital, No. 86 Ziyuan Road, Changsha, 410007, China
| | - Guangxian Yang
- Heart Center, Hunan Children's Hospital, No. 86 Ziyuan Road, Changsha, 410007, China
| | - Bing Zhou
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, 410007, Hunan, China
| | - Yunbin Xiao
- Heart Center, Hunan Children's Hospital, No. 86 Ziyuan Road, Changsha, 410007, China
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Lau I, Gupta A, Sun Z. Clinical Value of Virtual Reality versus 3D Printing in Congenital Heart Disease. Biomolecules 2021; 11:884. [PMID: 34198642 PMCID: PMC8232263 DOI: 10.3390/biom11060884] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/10/2021] [Accepted: 06/12/2021] [Indexed: 11/22/2022] Open
Abstract
Both three-dimensional (3D) printing and virtual reality (VR) are reported as being superior to the current visualization techniques in conveying more comprehensive visualization of congenital heart disease (CHD). However, little is known in terms of their clinical value in diagnostic assessment, medical education, and preoperative planning of CHD. This cross-sectional study aims to address these by involving 35 medical practitioners to subjectively evaluate VR visualization of four selected CHD cases in comparison with the corresponding 3D printed heart models (3DPHM). Six questionnaires were excluded due to incomplete sections, hence a total of 29 records were included for the analysis. The results showed both VR and 3D printed heart models were comparable in terms of the degree of realism. VR was perceived as more useful in medical education and preoperative planning compared to 3D printed heart models, although there was no significant difference in the ratings (p = 0.54 and 0.35, respectively). Twenty-one participants (72%) indicated both the VR and 3DPHM provided additional benefits compared to the conventional medical imaging visualizations. This study concludes the similar clinical value of both VR and 3DPHM in CHD, although further research is needed to involve more cardiac specialists for their views on the usefulness of these tools.
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Affiliation(s)
- Ivan Lau
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6102, Australia;
| | - Ashu Gupta
- Department of Medical Imaging, Fiona Stanley Hospital, Perth, WA 6150, Australia;
| | - Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6102, Australia;
- Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
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Basso ML, Gebran AM, Oliveira JD, Gebran KM, Bonatto LC, Farah MCK. Three-Dimensional-Printed Heart Prototype for Application in Pediatric Cardiology: An Initial Experiment. Arq Bras Cardiol 2021; 116:507-509. [PMID: 33909782 PMCID: PMC8159552 DOI: 10.36660/abc.20200086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 09/09/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Maíra Levorato Basso
- Hospital Pequeno PríncipeCuritibaPRBrasilHospital Pequeno Príncipe, Curitiba, PR - Brasil,Correspondência: Maíra Levorato Basso • Hospital Pequeno Principe - Rua Desembargador Motta, 1070. CEP 80250-060, Curitiba, PR – Brasil E-mail:
| | | | - Julia Dullius Oliveira
- Faculdades Pequeno PrincipeCuritibaPRBrasilFaculdades Pequeno Principe, Curitiba, PR – Brasil
| | - Katrin Möbius Gebran
- Faculdades Pequeno PrincipeCuritibaPRBrasilFaculdades Pequeno Principe, Curitiba, PR – Brasil
| | - Letícia Carlota Bonatto
- Faculdades Pequeno PrincipeCuritibaPRBrasilFaculdades Pequeno Principe, Curitiba, PR – Brasil
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Lee S, Squelch A, Sun Z. Quantitative Assessment of 3D Printed Model Accuracy in Delineating Congenital Heart Disease. Biomolecules 2021; 11:biom11020270. [PMID: 33673159 PMCID: PMC7917618 DOI: 10.3390/biom11020270] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 12/29/2022] Open
Abstract
Background: Three-dimensional (3D) printing is promising in medical applications, especially presurgical planning and the simulation of congenital heart disease (CHD). Thus, it is clinically important to generate highly accurate 3D-printed models in replicating cardiac anatomy and defects. The present study aimed to investigate the accuracy of the 3D-printed CHD model by comparing them with computed tomography (CT) images and standard tessellation language (STL) files. Methods: Three models were printed, comprising different CHD pathologies, including the tetralogy of Fallot (ToF), ventricular septal defect (VSD) and double-outlet right-ventricle (DORV). The ten anatomical locations were measured in each comparison. Pearson’s correlation coefficient, Bland–Altman analysis and intra-class correlation coefficient (ICC) determined the model accuracy. Results: All measurements with three printed models showed a strong correlation (r = 0.99) and excellent reliability (ICC = 0.97) when compared to original CT images, CT images of the 3D-printed models, STL files and 3D-printed CHD models. Conclusion: This study demonstrated the high accuracy of 3D-printed heart models with excellent correlation and reliability when compared to multiple source data. Further investigation into 3D printing in CHD should focus on the clinical value and the benefits to patients.
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Affiliation(s)
- Shenyuan Lee
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, GPO Box, U1987, Perth, WA 6845, Australia;
| | - Andrew Squelch
- Discipline of Exploration Geophysics, Western Australian School of Mines, Minerals, Energy and Chemical Engineering, Curtin University, Perth, WA 6845, Australia;
| | - Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, GPO Box, U1987, Perth, WA 6845, Australia;
- Correspondence: ; Tel.: +61-8-9266-7509; Fax: +61-8-9266-2377
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Francoisse CA, Sescleifer AM, King WT, Lin AY. Three-dimensional printing in medicine: a systematic review of pediatric applications. Pediatr Res 2021; 89:415-425. [PMID: 32503028 DOI: 10.1038/s41390-020-0991-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/01/2020] [Accepted: 05/04/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Three-dimensional printing (3DP) addresses distinct clinical challenges in pediatric care including: congenital variants, compact anatomy, high procedural risk, and growth over time. We hypothesized that patient-specific applications of 3DP in pediatrics could be categorized into concise, discrete categories of use. METHODS Terms related to "three-dimensional printing" and "pediatrics" were searched on PubMed, Scopus, Ovid MEDLINE, Cochrane CENTRAL, and Web of Science. Initial search yielded 2122 unique articles; 139 articles characterizing 508 patients met full inclusion criteria. RESULTS Four categories of patient-specific 3DP applications were identified: Teaching of families and medical staff (9.3%); Developing intervention strategies (33.9%); Procedural applications, including subtypes: contour models, guides, splints, and implants (43.0%); and Material manufacturing of shaping devices or prosthetics (14.0%). Procedural comparative studies found 3DP devices to be equivalent or better than conventional methods, with less operating time and fewer complications. CONCLUSION Patient-specific applications of Three-Dimensional Printing in Medicine can be elegantly classified into four major categories: Teaching, Developing, Procedures, and Materials, sharing the same TDPM acronym. Understanding this schema is important because it promotes further innovation and increased implementation of these devices to improve pediatric care. IMPACT This article classifies the pediatric applications of patient-specific three-dimensional printing. This is a first comprehensive review of patient-specific three-dimensional printing in both pediatric medical and surgical disciplines, incorporating previously described classification schema to create one unifying paradigm. Understanding these applications is important since three-dimensional printing addresses challenges that are uniquely pediatric including compact anatomy, unique congenital variants, greater procedural risk, and growth over time. We identified four classifications of patient-specific use: teaching, developing, procedural, and material uses. By classifying these applications, this review promotes understanding and incorporation of this expanding technology to improve the pediatric care.
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Affiliation(s)
- Caitlin A Francoisse
- Division of Plastic Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Anne M Sescleifer
- Division of Plastic Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Wilson T King
- Division of Pediatric Cardiology, Saint Louis University School of Medicine, St. Louis, MO, USA.,SSM Health Cardinal Glennon Children's Hospital at SLU, St. Louis, MO, USA
| | - Alexander Y Lin
- Division of Plastic Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA. .,SSM Health Cardinal Glennon Children's Hospital at SLU, St. Louis, MO, USA.
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Clinical Applications of Patient-Specific 3D Printed Models in Cardiovascular Disease: Current Status and Future Directions. Biomolecules 2020; 10:biom10111577. [PMID: 33233652 PMCID: PMC7699768 DOI: 10.3390/biom10111577] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/19/2020] [Accepted: 11/19/2020] [Indexed: 01/09/2023] Open
Abstract
Three-dimensional (3D) printing has been increasingly used in medicine with applications in many different fields ranging from orthopaedics and tumours to cardiovascular disease. Realistic 3D models can be printed with different materials to replicate anatomical structures and pathologies with high accuracy. 3D printed models generated from medical imaging data acquired with computed tomography, magnetic resonance imaging or ultrasound augment the understanding of complex anatomy and pathology, assist preoperative planning and simulate surgical or interventional procedures to achieve precision medicine for improvement of treatment outcomes, train young or junior doctors to gain their confidence in patient management and provide medical education to medical students or healthcare professionals as an effective training tool. This article provides an overview of patient-specific 3D printed models with a focus on the applications in cardiovascular disease including: 3D printed models in congenital heart disease, coronary artery disease, pulmonary embolism, aortic aneurysm and aortic dissection, and aortic valvular disease. Clinical value of the patient-specific 3D printed models in these areas is presented based on the current literature, while limitations and future research in 3D printing including bioprinting of cardiovascular disease are highlighted.
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Sezer S, Piai V, Kessels RP, ter Laan M. Information Recall in Pre-Operative Consultation for Glioma Surgery Using Actual Size Three-Dimensional Models. J Clin Med 2020; 9:jcm9113660. [PMID: 33203047 PMCID: PMC7698093 DOI: 10.3390/jcm9113660] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 02/07/2023] Open
Abstract
Three-dimensional (3D) technologies are being used for patient education. For glioma, a personalized 3D model can show the patient specific tumor and eloquent areas. We aim to compare the amount of information that is understood and can be recalled after a pre-operative consult using a 3D model (physically printed or in Augmented Reality (AR)) versus two-dimensional (2D) MR images. In this explorative study, healthy individuals were eligible to participate. Sixty-one participants were enrolled and assigned to either the 2D (MRI/fMRI), 3D (physical 3D model) or AR groups. After undergoing a mock pre-operative consultation for low-grade glioma surgery, participants completed two assessments (one week apart) testing information recall using a standardized questionnaire. The 3D group obtained the highest recall scores on both assessments (Cohen’s d = 1.76 and Cohen’s d = 0.94, respectively, compared to 2D), followed by AR and 2D, respectively. Thus, real-size 3D models appear to improve information recall as compared to MR images in a pre-operative consultation for glioma cases. Future clinical studies should measure the efficacy of using real-size 3D models in actual neurosurgery patients.
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Affiliation(s)
- Sümeyye Sezer
- Department of Neurosurgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Vitoria Piai
- Department of Medical Psychology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (V.P.); (R.P.C.K.)
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 AJ Nijmegen, The Netherlands
| | - Roy P.C. Kessels
- Department of Medical Psychology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (V.P.); (R.P.C.K.)
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 AJ Nijmegen, The Netherlands
| | - Mark ter Laan
- Department of Neurosurgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
- Correspondence:
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Utility of Three-Dimensional (3D) Modeling for Planning Structural Heart Interventions (with an Emphasis on Valvular Heart Disease). Curr Cardiol Rep 2020; 22:125. [PMID: 32789652 DOI: 10.1007/s11886-020-01354-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW Advanced imaging has played a vital role in the contemporary, rapid rise of structural heart interventions. 3D modeling and printing has emerged as one of the most recent imaging tools and the implementation of 3D modeling is expected to increase with further advances in imaging, print hardware, and materials. RECENT FINDINGS 3D modeling can be used to educate patients and clinical teams, provide ex vivo procedural simulation, and improve outcomes. Intra-procedural success rates may be improved, and post-procedural complications can be predicted more robustly with appropriate application of 3D modeling. Recent advances in technology have increased the availability of this tool, such that there can be more ready adoption into a routine clinical workflow. Familiarity with 3D modeling and its current utilization and role in structural interventions will help inform how to approach and adapt this exciting new technology.
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Vukicevic M, Filippini S, Little SH. Patient-Specific Modeling for Structural Heart Intervention: Role of 3D Printing Today and Tomorrow CME. Methodist Debakey Cardiovasc J 2020; 16:130-137. [PMID: 32670473 DOI: 10.14797/mdcj-16-2-130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Structural heart interventions (SHIs) are increasingly applicable in a wide range of heart defects, but the intricate and dynamic nature of cardiac structures can make SHIs challenging to perform. Three-dimensional (3D) printed modeling integrates advanced clinical imaging and 3D printing technology to replicate patient-specific anatomy for comprehensive planning and simulation of SHIs. This review discusses the basic principles of patient-specific 3D print model development, print material selection, and model fabrication and highlights how cardiovascular 3D printing can be used in preprocedural planning, device sizing, enhanced communication, and procedure simulation.
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Affiliation(s)
- Marija Vukicevic
- HOUSTON METHODIST DEBAKEY HEART & VASCULAR CENTER, HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS
| | - Stefano Filippini
- HOUSTON METHODIST DEBAKEY HEART & VASCULAR CENTER, HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS
| | - Stephen H Little
- HOUSTON METHODIST DEBAKEY HEART & VASCULAR CENTER, HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS
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Salavitabar A, Figueroa CA, Lu JC, Owens ST, Axelrod DM, Zampi JD. Emerging 3D technologies and applications within congenital heart disease: teach, predict, plan and guide. Future Cardiol 2020; 16:695-709. [PMID: 32628520 DOI: 10.2217/fca-2020-0004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
3D visualization technologies have evolved to become a mainstay in the management of congenital heart disease (CHD) with a growing presence within multiple facets. Printed and virtual 3D models allow for a more comprehensive approach to educating trainees and care team members. Computational fluid dynamics can take 3D modeling to the next level, by predicting post-procedural outcomes and helping to determine surgical approach. 3D printing and extended reality are developing resources for pre-procedural planning and intra-procedural guidance with the potential to revolutionize decision-making and procedural success. Challenges still remain within existing technologies and their applications to the CHD field. Addressing these gaps, both by those within and outside of CHD, will transform education and patient care within our field.
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Affiliation(s)
- Arash Salavitabar
- C.S. Mott Children's Hospital, University of Michigan Congenital Heart Center, Ann Arbor, MI 48109, USA
| | - C Alberto Figueroa
- Departments of Biomedical Engineering & Surgery, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jimmy C Lu
- C.S. Mott Children's Hospital, University of Michigan Congenital Heart Center, Ann Arbor, MI 48109, USA
| | - Sonal T Owens
- C.S. Mott Children's Hospital, University of Michigan Congenital Heart Center, Ann Arbor, MI 48109, USA
| | - David M Axelrod
- Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Jeffrey D Zampi
- C.S. Mott Children's Hospital, University of Michigan Congenital Heart Center, Ann Arbor, MI 48109, USA
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Bati AH, Guler E, Ozer MA, Govsa F, Erozkan K, Vatansever S, Ersin MS, Elmas ZN, Harman M. Surgical planning with patient-specific three-dimensional printed pancreaticobiliary disease models - Cross-sectional study. Int J Surg 2020; 80:175-183. [PMID: 32622058 DOI: 10.1016/j.ijsu.2020.06.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Three-dimensional (3D) printing has been increasingly used in medical applications with the creation of accurate patient-specific 3D printed models in medical imaging data. This study has been planned based on the fact that research on 3D printing in pancreaticobiliary disease is limited due to lack of studies on validation of model accuracy. METHODS This is an innovative study where general surgery residents are presented 5 distinct hepatopancreatobiliary disease scenarios to generate a perception and required to compare their perception level of these cases with magnetic resonance cholangiopancreatography (MRCP), 3D images and 1:1 solid models that the pathology, diverse diagnosis and presurgery diagnosis stages can be observed. This study is single-centered. RESULTS The dilated pancreaticobiliary intervention based on scenarios for general surgery residency was more original since there was no prior study that includes both model building and the evaluation of the perception created by the model. Five scenarios provided qualitative assessment with results showing the usefulness of 3D models when used as clinical tools in preoperative planning, simulation of interventional procedures, surgical education, and training. The perception level in the 3D model, MRCP (Z: 3.854, p: 0.000) and the 3D image (Z: 2.865, p: 0.004) was higher; likewise, the 3D-STL image was higher compared to the MRCP image (Z: 3.779, p: 0.000). All subspecialists agree that 3D models provided better understanding of dilated pancreaticobiliary pathoanatomy and improved surgical planning. CONCLUSIONS A thoroughly outlined genuine patient situation layout aimed for general surgery training can be installed and monitored with the support of 3D printing technology of this study. This can be utilized to develop the comprehension of pathoanatomical variations of complex pancreaticobiliary illness and to adopt a surgical approach.
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Affiliation(s)
| | | | - Mehmet Asim Ozer
- Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Turkey
| | - Figen Govsa
- Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Turkey.
| | - Kamil Erozkan
- Department of General Surgery, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Safa Vatansever
- Department of General Surgery, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Muhtar Sinan Ersin
- Department of General Surgery, Faculty of Medicine, Ege University, Izmir, Turkey
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Abstract
BACKGROUND Cardiac catheterisations for CHD produce anxiety for patients and families. Current strategies to mitigate anxiety and explain complex anatomy include pre-procedure meetings and educational tools (cardiac diagrams, echocardiograms, imaging, and angiography). More recently, three-dimensionally printed patient-specific models can be added to the armamentarium. The purpose of this study was to evaluate the efficacy of pre-procedure meetings and of different educational tools to reduce patient and parent anxiety before a catheterisation. METHODS Prospective study of patients ≥18 and parents of patients <18 scheduled for clinically indicated catheterisations. Patients completed online surveys before and after meeting with the interventional cardiologist, who was blinded to study participation. Both the pre- and post-meeting surveys measured anxiety using the State-Trait Anxiety Inventory. In addition, the post-meeting survey evaluated the subjective value (from 1 to 4) of individual educational tools: physician discussion, cardiac diagrams, echocardiograms, prior imaging, angiograms and three-dimensionally printed cardiac models. Data were compared using paired t-tests. RESULTS Twenty-three patients consented to participate, 16 had complete data for evaluation. Mean State-Trait Anxiety Inventory scores were abnormally elevated at baseline and decreased into the normal range after the pre-procedure meeting (39.8 versus 31, p = 0.008). Physician discussion, angiograms, and three-dimensional models were reported to be most effective at increasing understanding and reducing anxiety. CONCLUSION In this pilot study, we have found that pre-catheterisation meetings produce a measurable decrease in patient and family anxiety before a procedure. Discussions of the procedure, angiograms, and three-dimensionally printed cardiac models were the most effective educational tools.
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3-Dimensional personalized planning for transcatheter pulmonary valve implantation in a dysfunctional right ventricular outflow tract. Int J Cardiol 2020; 309:33-39. [DOI: 10.1016/j.ijcard.2019.12.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/25/2019] [Accepted: 12/04/2019] [Indexed: 11/23/2022]
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Zakare-Fagbamila RT, Howell E, Choi AY, Cheng TZ, Clement M, Neely M, Gottfried ON. Clinic Satisfaction Tool Improves Communication and Provides Real-Time Feedback. Neurosurgery 2020; 84:908-918. [PMID: 29669027 DOI: 10.1093/neuros/nyy137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/22/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patient-reported assessments of the clinic experience are increasingly important for improving the delivery of care. The Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey is the current standard for evaluating patients' clinic experience, but its format gives 2-mo delayed feedback on a small proportion of patients in clinic. Furthermore, it fails to give specific actionable results on individual encounters. OBJECTIVE To develop and assess the impact of a single-page Clinic Satisfaction Tool (CST) to demonstrate real-time feedback, individualized responses, interpretable and actionable feedback, improved patient satisfaction and communication scores, increased physician buy-in, and overall feasibility. METHODS We assessed CST use for 12 mo and compared patient-reported outcomes to the year prior. We assessed all clinic encounters for patient satisfaction, all physicians for CG-CAHPS global rating, and physician communication scores, and evaluated the physician experience 1 yr after implementation. RESULTS During implementation, 14 690 patients were seen by 12 physicians, with a 96% overall CST utilization rate. Physicians considered the CST superior to CG-CAHPS in providing immediate feedback. CG-CAHPS global scores trended toward improvement and were predicted by CST satisfaction scores (P < .05). CG-CAHPS physician communication scores were also predicted by CST satisfaction scores (P < .01). High CST satisfaction scores were predicted by high utilization (P < .05). Negative feedback dropped significantly over the course of the study (P < .05). CONCLUSION The CST is a low-cost, high-yield improvement to the current method of capturing the clinic experience, improves communication and satisfaction between physicians and patients, and provides real-time feedback to physicians.
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Affiliation(s)
| | | | - Ashley Y Choi
- School of Medicine, Duke University, Durham, North Carolina
| | - Tracy Z Cheng
- School of Medicine, Duke University, Durham, North Carolina
| | - Mary Clement
- Department of Musculoskeletal and Spine Services, Duke University Medical Center, Durham, North Carolina
| | - Megan Neely
- Depart-ment of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina
| | - Oren N Gottfried
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
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Hermsen JL, Roldan-Alzate A, Anagnostopoulos PV. Three-dimensional printing in congenital heart disease. J Thorac Dis 2020; 12:1194-1203. [PMID: 32274200 PMCID: PMC7138972 DOI: 10.21037/jtd.2019.10.38] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Three-dimensional printing (3Dp) has a broad array of medical applications and has been applied extensively in congenital heart disease given the variety and complexity of lesions encountered. 3Dps are unique when compared to other imaging modalities in that they are theoretically equally interpretable by radiologists, cardiologists and surgeons. The literature regarding 3Dp in congenital heart disease is recent and burgeoning. This review, categorized by application, should provide the reader with a comprehensive, albeit not complete, overview of 3Dp in congenital heart disease during the last decade.
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Affiliation(s)
- Joshua L Hermsen
- University of Wisconsin-Madison and American Family Children's Hospital, Madison, WI, USA
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Sun Z. Use of Three-dimensional Printing in the Development of Optimal Cardiac CT Scanning Protocols. Curr Med Imaging 2020; 16:967-977. [PMID: 32107994 DOI: 10.2174/1573405616666200124124140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 01/01/2023]
Abstract
Three-dimensional (3D) printing is increasingly used in medical applications with most of the studies focusing on its applications in medical education and training, pre-surgical planning and simulation, and doctor-patient communication. An emerging area of utilising 3D printed models lies in the development of cardiac computed tomography (CT) protocols for visualisation and detection of cardiovascular disease. Specifically, 3D printed heart and cardiovascular models have shown potential value in the evaluation of coronary plaques and coronary stents, aortic diseases and detection of pulmonary embolism. This review article provides an overview of the clinical value of 3D printed models in these areas with regard to the development of optimal CT scanning protocols for both diagnostic evaluation of cardiovascular disease and reduction of radiation dose. The expected outcomes are to encourage further research towards this direction.
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Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Western Australia, 6845, Australia
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