1
|
Ørbæk Andersen M, Smerup MH, Munk K, Mortensen UM, Nørgaard BL, Helvind M, Andersen HØ, Linde JJ. Computed tomographic-based three-dimensional printing of giant coronary artery fistulas to guide surgical strategy: a case series. Eur Heart J Case Rep 2024; 8:ytad413. [PMID: 38374985 PMCID: PMC10875921 DOI: 10.1093/ehjcr/ytad413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 08/07/2023] [Accepted: 08/16/2023] [Indexed: 02/21/2024]
Abstract
Background Coronary artery fistulas (CAFs) are abnormal communications between the coronary arteries and the heart chambers, arteries, or veins, potentially leading to significant shunting, myocardial ischaemia and heart failure. Computed tomographic (CT) angiography or conventional invasive angiography is the reference standard for the diagnosis of coronary fistulas. The fistula anatomy can become very complex, which makes surgical or interventional planning challenging. Case summary We report two cases of hugely dilated and tortuous coronary circumflex artery fistulas draining into the coronary sinus. Both patients were followed up for more than 10 years because of very complex coronary fistula anatomy and mild symptoms. From two-dimensional (2D) sliced CT images alone it, was uncertain whether surgery was feasible. However, since both patients had symptom progression (Patient 1 developed heart failure, and Patient 2 had recurrent pericardial effusions), three-dimensional (3D) heart models were printed for better understanding of the complex fistula anatomy and improved surgical planning. Both patients had successful surgery and symptomatic relief at follow-up. Discussion The delay in surgery, until clinical deterioration, may partly be a consequence of a general reluctance in performing complex surgery in patients with CAFs. As of now, CT-based 3D printing has primarily been used in isolated cases. However, 3D printing is evolving rapidly and supplementing 2D sliced CT images with a physical 3D heart model may improve the anatomical understanding and pre-surgical planning that could lead to better surgical outcome.
Collapse
Affiliation(s)
- Mads Ørbæk Andersen
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Morten H Smerup
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Kim Munk
- Department of Cardiology, Aarhus University Hospital, 8200 Århus, Denmark
| | | | | | - Morten Helvind
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Henrik Ørbæk Andersen
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Jesper James Linde
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| |
Collapse
|
2
|
Shabbak A, Masoumkhani F, Fallah A, Amani-Beni R, Mohammadpour H, Shahbazi T, Bakhshi A. 3D Printing for Cardiovascular Surgery and Intervention: A Review Article. Curr Probl Cardiol 2024; 49:102086. [PMID: 37716537 DOI: 10.1016/j.cpcardiol.2023.102086] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/18/2023]
Abstract
3D printing technology can be applied to practically every aspect of modern life, fulfilling the needs of people from various backgrounds. The utilization of 3D printing in the context of adult heart disease can be succinctly categorized into 3 primary domains: preoperative strategizing or simulation, medical instruction, and clinical consultations. 3D-printed model utilization improves surgical planning and intraoperative decision-making and minimizes surgical risks, and it has demonstrated its efficacy as an innovative educational tool for aspiring surgeons with limited practical exposure. Despite all the applications of 3D printing, it has not yet been shown to improve long-term outcomes, including safety. There are no data on the outcomes of controlled trials available. To appropriately diagnose heart disease, 3D-printed models of the heart can provide a better understanding of the intracardiac anatomy and provide all the information needed for operative planning. Experientially, 3D printing provides a wide range of perceptions for understanding lower extremity arteries' spatial geometry and anatomical features of pathology. Practicing cardiac surgery processes using objects printed using 3D imaging data can become the norm rather than the exception, leading to improved accuracy and quality of treatment. This study aimed to review the various applications of 3D printing technology in cardiac surgery and intervention.
Collapse
Affiliation(s)
- Ali Shabbak
- Research Committee, School of Medicine, Guilan University of Medical Science, Rasht, Iran
| | - Fateme Masoumkhani
- Department of cardiology, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Amir Fallah
- Research Committee, School of Medicine, Guilan University of Medical Science, Rasht, Iran
| | - Reza Amani-Beni
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hanieh Mohammadpour
- Research Committee, School of Medicine, Guilan University of Medical Science, Rasht, Iran
| | - Taha Shahbazi
- Neurosurgery Research Group (NRG), Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Arash Bakhshi
- Remember of Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
| |
Collapse
|
3
|
An impact of three dimensional techniques in virtual reality. Int J Health Sci (Qassim) 2022. [DOI: 10.53730/ijhs.v6ns4.6481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Three dimensional (3D) imaging play a prominent role in the diagnosis, treatment planning, and post-therapeutic monitoring of patients with Rheumatic Heart Disease (RHD) or mitral valve disease. More interactive and realistic medical experiences take an advantage of advanced visualization techniques like augmented, mixed, and virtual reality to analyze the 3D models. Further, 3D printed mitral valve model is being used in medical field. All these technologies improve the understanding of the complex morphologies of mitral valve disease. Real-time 3D Echocardiography has attracted much more attention in medical researches because it provides interactive feedback to acquire high-quality images as well as timely spatial information of the scanned area and hence is necessary for intraoperative ultrasound examinations. In this article, three dimensional techniques and its impacts in mitral valve disease are reviewed. Specifically, the data acquisition techniques, reconstruction algorithms with clinical applications are presented. Moreover, the advantages and disadvantages of state-of-the-art approaches are discussed in detail.
Collapse
|
4
|
Wang C, Zhang L, Qin T, Xi Z, Sun L, Wu H, Li D. 3D printing in adult cardiovascular surgery and interventions: a systematic review. J Thorac Dis 2020; 12:3227-3237. [PMID: 32642244 PMCID: PMC7330795 DOI: 10.21037/jtd-20-455] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
3D printing in adult cardiac and vascular surgery has been evaluated over the last 10 years, and all of the available literature reports benefits from the use of 3D models. In the present study, we analyzed the current applications of 3D printing for adult cardiovascular disease treated with surgical or catheter-based interventions, including the clinical medical simulation of physiological or pathology conducted with 3D printing in this field. A search of PubMed and MEDLINE databases were supplemented by searching through bibliographies of key articles. Thereafter, data on demographic, clinical scenarios and application, imaging modality, purposes of using with 3D printing, outcomes and follow-up were extracted. A total of 43 articles were deemed eligible and included. 296 patients (mean age: 65.4±14.2 years; male, 58.2%) received 3D printing for cardiac and vascular surgery or conditions [percutaneous left atrial appendage occlusion (LAAO), TAVR, mitral valve disease, aortic valve replacement, coronary artery abnormality, HOCM, aortic aneurysm and aortic dissection, Kommerell's diverticulum, primary cardiac tumor and ventricular aneurysm]. Eight papers reported the utility of 3D printing in the medical simulator and training fields. Most studies were conducted starting in 2014. Twenty-six was case report. The major scenario used with 3D printing technology was LAAO (50.3%) and followed by TAVR (17.6%). CT and echocardiography were two main imaging techniques that were used to generate 3D-printed heart models. All studies showed that 3D-printed models were helpful for preoperative planning, orientation, and medical teaching. The important finding is that 3D printing provides a unique patient-specific method to assess complex anatomy and is helpful for intraoperative orientation, decision-making, creating functional models, and teaching adult cardiac and vascular surgery, including catheter-based heart surgery.
Collapse
Affiliation(s)
- Changtian Wang
- Department of Cardiovascular Surgery, Jinling Hospital, Nanjing University, School Medicine, Nanjing 210002, China
| | - Lei Zhang
- Department of Cardiovascular Surgery, Jinling Hospital, Nanjing University, School Medicine, Nanjing 210002, China
| | - Tao Qin
- Department of Cardiovascular Surgery, Jinling Hospital, Nanjing University, School Medicine, Nanjing 210002, China
| | - Zhilong Xi
- Department of Cardiovascular Surgery, Jinling Hospital, Nanjing University, School Medicine, Nanjing 210002, China
| | - Lei Sun
- Department of Cardiovascular Surgery, Jinling Hospital, Nanjing University, School Medicine, Nanjing 210002, China
| | - Haiwei Wu
- Department of Cardiovascular Surgery, Jinling Hospital, Nanjing University, School Medicine, Nanjing 210002, China
| | - Demin Li
- Department of Cardiovascular Surgery, Jinling Hospital, Nanjing University, School Medicine, Nanjing 210002, China
| |
Collapse
|