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Sakai AKF, Cestari IN, de Sales E, Mazzetto M, Cestari IA. Metamaterial design for aortic aneurysm simulation using 3D printing. 3D Print Med 2024; 10:29. [PMID: 39110290 PMCID: PMC11304610 DOI: 10.1186/s41205-024-00219-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/18/2024] [Indexed: 08/10/2024] Open
Abstract
INTRODUCTION The use of three-dimensional (3D) printed anatomic models is steadily increasing in research and as a tool for clinical decision-making. The mechanical properties of polymers and metamaterials were investigated to evaluate their application in mimicking the biomechanics of the aortic vessel wall. METHODOLOGY Uniaxial tensile tests were performed to determine the elastic modulus, mechanical stress, and strain of 3D printed samples. We used a combination of materials, designed to mimic biological tissues' properties, the rigid VeroTM family, and the flexible Agilus30™. Metamaterials were designed by tessellating unit cells that were used as lattice-reinforcement to tune their mechanical properties. The lattice-reinforcements were based on two groups of patterns, mainly responding to the movement between links/threads (chain and knitted) or to deformation (origami and diamond crystal). The mechanical properties of the printed materials were compared with the characteristics of healthy and aneurysmal aortas. RESULTS Uniaxial tensile tests showed that the use of a lattice-reinforcement increased rigidity and may increase the maximum stress generated. The pattern and material of the lattice-reinforcement may increase or reduce the strain at maximum stress, which is also affected by the base material used. Printed samples showed max stress ranging from 0.39 ± 0.01 MPa to 0.88 ± 0.02 MPa, and strain at max stress ranging from 70.44 ± 0.86% to 158.21 ± 8.99%. An example of an application was created by inserting a metamaterial designed as a lattice-reinforcement on a model of the aorta to simulate an abdominal aortic aneurysm. CONCLUSION The maximum stresses obtained with the printed models were similar to those of aortic tissue reported in the literature, despite the fact that the models did not perfectly reproduce the biological tissue behavior.
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Affiliation(s)
- Arthur K F Sakai
- Electrical Engineering Graduate Program, Telecommunications and Control Engineering Department, Polytechnic School, University of São Paulo, São Paulo, Brazil
| | - Ismar N Cestari
- Laboratório de Bioengenharia, Instituto do Coração, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Eraldo de Sales
- Laboratório de Bioengenharia, Instituto do Coração, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo Mazzetto
- Laboratório de Bioengenharia, Instituto do Coração, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Idágene A Cestari
- Electrical Engineering Graduate Program, Telecommunications and Control Engineering Department, Polytechnic School, University of São Paulo, São Paulo, Brazil.
- Laboratório de Bioengenharia, Instituto do Coração, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
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Krishnaswamy A, Kassab J, Harb SC. Beyond Simple Visualization: A New Reality for Structural Heart Interventions? J Am Heart Assoc 2024; 13:e036238. [PMID: 39041623 DOI: 10.1161/jaha.124.036238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Affiliation(s)
| | - Joseph Kassab
- Heart and Vascular Institute, Cleveland Clinic Cleveland OH USA
| | - Serge C Harb
- Heart and Vascular Institute, Cleveland Clinic Cleveland OH USA
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Capellini K, Ait-Ali L, Pak V, Cantinotti M, Murzi M, Vignali E, Fanni BM, Clemente A, Celi S, Gasparotti E. Three-dimensional printed models as an effective tool for the management of complex congenital heart disease. Front Bioeng Biotechnol 2024; 12:1369514. [PMID: 39157439 PMCID: PMC11327011 DOI: 10.3389/fbioe.2024.1369514] [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: 01/12/2024] [Accepted: 07/15/2024] [Indexed: 08/20/2024] Open
Abstract
Introduction Three-dimensional printed models are widely used in the medical field for surgical and interventional planning. In the context of complex cardiovascular defects such as pediatric congenital heart diseases (CHDs), the adoption of 3D printed models could be an effective tool to improve decision-making. In this paper, an investigation was conducted into the characteristics of 3D printed models and their added value in understanding and managing complex pediatric congenital heart disease, also considering the associated cost. Methods Volumetric MRI and CT images of subjects with complex CHDs were retrospectively segmented, and the associated 3D models were reconstructed. Different 3D printing technologies and materials were evaluated to obtain the 3D printed models of cardiac structures. An evaluation of time and costs associated with the 3D printing procedure was also provided. A two-level 3D printed model assessment was carried out to investigate the most suitable 3D printing technology for the management of complex CHDs and the effectiveness of 3D printed models in the pre-surgical planning and surgical strategies' simulations. Results Among the different techniques, selective laser sintering resulted to be the most suitable due to its reduced time and cost and for the positive clinical feedback (procedure simulation, surface finish, and reproduction of details). Conclusion The adoption of 3D printed models contributes as an effective tool in the management of complex CHDs, enabling planning and simulations of surgical procedures in a safer way.
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Affiliation(s)
- Katia Capellini
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | | | - Vitali Pak
- Department of Pediatric Cardiac Surgery, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | | | - Michele Murzi
- Department of Adult Cardiac Surgery, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - Emanuele Vignali
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - Benigno Marco Fanni
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - Alberto Clemente
- Department of Clinical Imaging, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Simona Celi
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - Emanuele Gasparotti
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Massa, Italy
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Tsolakis IA, Lyros I, Christopoulou I, Tsolakis AI, Papadopoulos MA. Comparing the accuracy of 3 different liquid crystal display printers for dental model printing. Am J Orthod Dentofacial Orthop 2024; 166:7-14. [PMID: 38647515 DOI: 10.1016/j.ajodo.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 01/01/2024] [Accepted: 01/01/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION This study aimed to evaluate the accuracy in terms of trueness and precision of 3 different liquid crystal display (LCD) printers with different cost levels. METHODS Three LCD 3-dimensional (3D) printers were categorized into tiers 1-3 on the basis of cost level. The printers' accuracies were assessed in terms of trueness and precision. For this research, 10 standard tessellation language (STL) reference files were used. For trueness, each STL file was printed once with each 3D printer. For precision, 1 randomly chosen STL file was printed 10 times with each 3D printer. After that, a model scanner was used to scan the models, and STL comparisons were performed using reverse engineering software. For the measurements regarding trueness and precision, the Friedman test was used. RESULTS There were significant differences among the 3 printers (P <0.05). The trueness and precision error were lower in models printed with a tier-1 printer than in the remaining 3D printers (P <0.05). The tier-2 and -3 printers presented very similar performance. CONCLUSIONS LCD 3D printers can be accurately used in orthodontics for model printing depending on the specific orthodontic use. The cost of a printer is relevant to the results only for the higher expense of the 3D printer in this study.
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Affiliation(s)
- Ioannis A Tsolakis
- Department of Orthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece; Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH.
| | - Ioannis Lyros
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Isidora Christopoulou
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Apostolos I Tsolakis
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH; Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Moschos A Papadopoulos
- Department of Orthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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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] [Track Full Text] [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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Faza NN, Harb SC, Wang DD, van den Dorpel MMP, Van Mieghem N, Little SH. Physical and Computational Modeling for Transcatheter Structural Heart Interventions. JACC Cardiovasc Imaging 2024; 17:428-440. [PMID: 38569793 DOI: 10.1016/j.jcmg.2024.01.014] [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: 04/17/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 04/05/2024]
Abstract
Structural heart disease interventions rely heavily on preprocedural planning and simulation to improve procedural outcomes and predict and prevent potential procedural complications. Modeling technologies, namely 3-dimensional (3D) printing and computational modeling, are nowadays increasingly used to predict the interaction between cardiac anatomy and implantable devices. Such models play a role in patient education, operator training, procedural simulation, and appropriate device selection. However, current modeling is often limited by the replication of a single static configuration within a dynamic cardiac cycle. Recognizing that health systems may face technical and economic limitations to the creation of "in-house" 3D-printed models, structural heart teams are pivoting to the use of computational software for modeling purposes.
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Affiliation(s)
- Nadeen N Faza
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | | | | | | | | | - Stephen H Little
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA.
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Chrysostomidis G, Apostolos A, Papanikolaou A, Konstantinou K, Tsigkas G, Koliopoulou A, Chamogeorgakis T. The Application of Precision Medicine in Structural Heart Diseases: A Step towards the Future. J Pers Med 2024; 14:375. [PMID: 38673001 PMCID: PMC11051532 DOI: 10.3390/jpm14040375] [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: 02/07/2024] [Revised: 03/20/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024] Open
Abstract
The personalized applications of 3D printing in interventional cardiology and cardiac surgery represent a transformative paradigm in the management of structural heart diseases. This review underscores the pivotal role of 3D printing in enhancing procedural precision, from preoperative planning to procedural simulation, particularly in valvular heart diseases, such as aortic stenosis and mitral regurgitation. The ability to create patient-specific models contributes significantly to predicting and preventing complications like paravalvular leakage, ensuring optimal device selection, and improving outcomes. Additionally, 3D printing extends its impact beyond valvular diseases to tricuspid regurgitation and non-valvular structural heart conditions. The comprehensive synthesis of the existing literature presented here emphasizes the promising trajectory of individualized approaches facilitated by 3D printing, promising a future where tailored interventions based on precise anatomical considerations become standard practice in cardiovascular care.
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Affiliation(s)
- Grigorios Chrysostomidis
- Second Department of Adult Cardiac Surgery—Heart and Lung Transplantation, Onassis Cardiac Surgery Center, 176 74 Athens, Greece; (G.C.); (A.K.); (T.C.)
| | - Anastasios Apostolos
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippocration General Hospital, 115 27 Athens, Greece;
| | - Amalia Papanikolaou
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippocration General Hospital, 115 27 Athens, Greece;
| | - Konstantinos Konstantinou
- Royal Brompton and Harefield Hospitals, Guy’s and St Thomas’ NHS Foundation Trust, London 26504, UK;
| | - Grigorios Tsigkas
- Department of Cardiology, University Hospital of Patras, 265 04 Patras, Greece;
| | - Antigoni Koliopoulou
- Second Department of Adult Cardiac Surgery—Heart and Lung Transplantation, Onassis Cardiac Surgery Center, 176 74 Athens, Greece; (G.C.); (A.K.); (T.C.)
| | - Themistokles Chamogeorgakis
- Second Department of Adult Cardiac Surgery—Heart and Lung Transplantation, Onassis Cardiac Surgery Center, 176 74 Athens, Greece; (G.C.); (A.K.); (T.C.)
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Giorgi J, Barbagelata A, Luoma-Overstreet G, Kaplinsky E, Jorge SDC, Scanavacca M, Scordamaglio PR, Mentz RJ. 3D Printing for Left Ventricular Assist Device Exchange: Insights From Real-World Experience. JACC Case Rep 2024; 29:102194. [PMID: 38464795 PMCID: PMC10920099 DOI: 10.1016/j.jaccas.2023.102194] [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: 08/11/2023] [Revised: 11/13/2023] [Accepted: 11/22/2023] [Indexed: 03/12/2024]
Abstract
Left ventricular assist devices (LVADs) are used in end-stage heart failure. Inadequate positioning of the inflow cannula may necessitate replacement of the LVAD. We present the successful use of a three-dimensional printed model used to optimize surgical planning and allow for simulation and training for the LVAD exchange procedure.
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Affiliation(s)
- Juliana Giorgi
- Sírio Libanês Hospital, São Paulo, Brazil
- Albert Einstein Hospital, São Paulo, Brazil
| | - Alejandro Barbagelata
- Universidad Catolica Argentina, Buenos Aires, Argentina
- Duke University, Durham, North Carolina, USA
| | | | - Edgardo Kaplinsky
- Barcelona University, Badalona Municipal Hospital, Badalona, Barcelona, Spain
| | - Sergio do Carmo Jorge
- Sírio Libanês Hospital, São Paulo, Brazil
- Albert Einstein Hospital, São Paulo, Brazil
| | - Mauricio Scanavacca
- Sírio Libanês Hospital, São Paulo, Brazil
- Albert Einstein Hospital, São Paulo, Brazil
- Instituto do Coração do Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
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Jackson E, Markovic LE, Perlini M. Comparison of two-dimensional imaging to three-dimensional modeling of intrahepatic portosystemic shunts using computed tomography angiography. Vet Radiol Ultrasound 2024; 65:130-137. [PMID: 38279771 DOI: 10.1111/vru.13337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/28/2023] [Accepted: 12/28/2023] [Indexed: 01/28/2024] Open
Abstract
Computed tomography angiography (CTA) is used for the diagnosis of intrahepatic portosystemic shunts (IHPSS). When planning for transcatheter intervention, caudal vena cava (CVC) measurements are typically obtained from two-dimensional (2D) imaging to aid in stent selection. We hypothesized that clinically applicable three-dimensional (3D) IHPSS models can be generated, and CVC measurements will not differ between 2D images and 3D models. Computed tomography angiography datasets from client-owned dogs with IHPSS at the University of Georgia Veterinary Teaching Hospital from 2016 to 2022 were analyzed. Materialise Mimics 25.0 and 3-matic 17.0 were used for 3D modeling. Caudal vena cava diameters were measured in 2D dorsal and transverse planes 20 mm cranial and caudal from the shunt ostium and were compared with CVC diameters from 3D models. Length was measured in the 2D dorsal plane between midpoints of each diameter and compared to the 3D model length. Data are presented as mean (SD), and intraclass correlation coefficients were performed. Three-dimensional models were generated for 32 IHPSS (15 right-, 12 left-, and five central-divisional). Two-dimensional dorsal and transverse area-associated diameter measurements were 16.7 mm (5.6) and 15.5 mm (4.2) cranial; 14.9 mm (4.2) and 14.3 mm (3.7) caudal. Three-dimensional area-associated diameter measurements were 15.3 mm (4.4) cranial and 14.0 mm (3.6) caudal. The 2D length was 61.5 mm (7.1) compared with 3D 59.9 mm (7.2). Intraclass correlation coefficients comparing 2D and 3D diameters were all >0.80, indicating very good agreement, with good agreement (>0.60) for length. Clinically applicable 3D IHPSS models can be generated using engineering software. Measurements from 3D models are consistent with 2D planar imaging. Both 2D CTA and 3D virtual models can be utilized for preprocedural planning, depending on clinician preference.
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Affiliation(s)
- Erin Jackson
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Lauren E Markovic
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Michael Perlini
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
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Lagerburg V, van den Boorn M, Vorrink S, Amajjar I, Witbreuk MMEH. The clinical value of preoperative 3D planning and 3D surgical guides for Imhäuser osteotomy in slipped capital femoral epipysis: a retrospective study. 3D Print Med 2024; 10:8. [PMID: 38427154 PMCID: PMC10908070 DOI: 10.1186/s41205-024-00205-2] [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: 07/24/2023] [Accepted: 02/12/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Accurate repositioning of the femoral head in patients with Slipped Capital Femoral Epiphysis (SCFE) undergoing Imhäuser osteotomy is very challenging. The objective of this study is to determine if preoperative 3D planning and a 3D-printed surgical guide improve the accuracy of the placement of the femoral head. METHODS This retrospective study compared outcome parameters of patients who underwent a classic Imhäuser osteotomy from 2009 to 2013 with those who underwent an Imhäuser osteotomy using 3D preoperative planning and 3D-printed surgical guides from 2014 to 2021. The primary endpoint was improvement in Range of Motion (ROM) of the hip. Secondary outcomes were radiographic improvement (Southwick angle), patient-reported clinical outcomes regarding hip and psychosocial complaints assessed with two questionnaires and duration of surgery. RESULTS In the 14 patients of the 3D group radiographic improvement was slightly greater and duration of surgery was slightly shorter than in the 7 patients of the classis Imhäuser group. No difference was found in the ROM, and patient reported clinical outcomes were slightly less favourable. CONCLUSIONS Surprisingly we didn't find a significant difference between the two groups. Further research on the use of 3D planning an 3D-printed surgical guides is needed. TRIAL REGISTRATION Approval for this study was obtained of the local ethics committees of both hospitals.
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Affiliation(s)
| | | | - Sigrid Vorrink
- Department of Orthopedic Surgery, OLVG, Amsterdam, The Netherlands
| | - Ihsane Amajjar
- Department of Orthopedic Surgery, OLVG, Amsterdam, The Netherlands
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Alanazi KK, Alzaid AA, Alotaibi A, Almehisni N, Alzahrani G, Gufran K. Assessment of knowledge and practices of additive manufacturing in dentistry among university teaching faculty in Saudi Arabia. BMC Oral Health 2024; 24:271. [PMID: 38402388 PMCID: PMC10893747 DOI: 10.1186/s12903-024-04037-8] [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: 08/27/2023] [Accepted: 02/16/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND In recent era, digitalization in the dental sciences has been observed in wide ranges. This cross-sectional study aimed to assess knowledge and practice of additive manufacturing (AM) in dentistry among university teaching faculty in Saudi Arabia. METHODS A questionnaire was prepared and validated to distribute to the different dental colleges in Saudi Arabia. The questionnaire was divided into three parts: demographic information, knowledge and practices of AM among the dental teaching faculty. After receiving all the responses, descriptive statistics were used for the frequency distribution of all the responses. RESULTS A total of 367 responses were received from the different faculty members. Most of the participants were male (67.30%), holding assistant professor (52.50%) positions in the field of prosthodontics (23.40%). In terms of knowledge, even though most of the participants were aware of AM (64.30%); however, do not understand the AM techniques (33.50). Moreover, 71.90% of the participants had no experience working with AM and only 13.60% of participants used AM in their respective dental colleges. CONCLUSION AM techniques are not commonly used in the field of dentistry in Saudi Arabia; therefore, more platforms should have created to enhance the knowledge and practice of AM in the current population.
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Affiliation(s)
- Khalid K Alanazi
- Conservative Dental Science Department, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj, 11942, Saudi Arabia.
| | - Abdulaziz A Alzaid
- Restorative and Prosthetic Dental Sciences Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh 11481, Saudi Arabia
| | - Adel Alotaibi
- King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh 11481, Saudi Arabia
- Preventive Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Nora Almehisni
- King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh 11481, Saudi Arabia
- Dental Intern, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Ghida Alzahrani
- King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh 11481, Saudi Arabia
- Dental Intern, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Khalid Gufran
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj, 11942, Saudi Arabia
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Henriques J, Amaro AM, Piedade AP. Biomimicking Atherosclerotic Vessels: A Relevant and (Yet) Sub-Explored Topic. Biomimetics (Basel) 2024; 9:135. [PMID: 38534820 DOI: 10.3390/biomimetics9030135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/28/2024] Open
Abstract
Atherosclerosis represents the etiologic source of several cardiovascular events, including myocardial infarction, cerebrovascular accidents, and peripheral artery disease, which remain the leading cause of mortality in the world. Numerous strategies are being delineated to revert the non-optimal projections of the World Health Organization, by both designing new diagnostic and therapeutic approaches or improving the interventional procedures performed by physicians. Deeply understanding the pathological process of atherosclerosis is, therefore, mandatory to accomplish improved results in these trials. Due to their availability, reproducibility, low expensiveness, and rapid production, biomimicking physical models are preferred over animal experimentation because they can overcome some limitations, mainly related to replicability and ethical issues. Their capability to represent any atherosclerotic stage and/or plaque type makes them valuable tools to investigate hemodynamical, pharmacodynamical, and biomechanical behaviors, as well as to optimize imaging systems and, thus, obtain meaningful prospects to improve the efficacy and effectiveness of treatment on a patient-specific basis. However, the broadness of possible applications in which these biomodels can be used is associated with a wide range of tissue-mimicking materials that are selected depending on the final purpose of the model and, consequently, prioritizing some materials' properties over others. This review aims to summarize the progress in fabricating biomimicking atherosclerotic models, mainly focusing on using materials according to the intended application.
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Affiliation(s)
- Joana Henriques
- University of Coimbra, CEMMPRE, ARISE, Department of Mechanical Engineering, 3030-788 Coimbra, Portugal
| | - Ana M Amaro
- University of Coimbra, CEMMPRE, ARISE, Department of Mechanical Engineering, 3030-788 Coimbra, Portugal
| | - Ana P Piedade
- University of Coimbra, CEMMPRE, ARISE, Department of Mechanical Engineering, 3030-788 Coimbra, Portugal
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Zhang X, Yi K, Xu JG, Wang WX, Liu CF, He XL, Wang FN, Zhou GL, You T. Application of three-dimensional printing in cardiovascular diseases: a bibliometric analysis. Int J Surg 2024; 110:1068-1078. [PMID: 37924501 PMCID: PMC10871659 DOI: 10.1097/js9.0000000000000868] [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: 08/12/2023] [Accepted: 10/22/2023] [Indexed: 11/06/2023]
Abstract
AIM This paper aimed to explore the application of three-dimensional (3D) printing in cardiovascular diseases, to reach an insight in this field and prospect the future trend. METHODS The articles were selected from the Web of Science Core Collection database. Excel 2019, VOSviewer 1.6.16, and CiteSpace 6.1.R6 were used to analyze the information. RESULTS A total of 467 papers of 3D printing in cardiovascular diseases were identified, and the first included literature appeared in 2000. A total of 692 institutions from 52 countries participated in the relevant research, while the United States of America contributed to 160 articles and were in a leading position. The most productive institution was Curtin University , and Zhonghua Sun who has posted the most articles ( n =8) was also from there. The Frontiers in Cardiovascular Medicine published most papers ( n =25). The Journal of Thoracic and Cardiovascular Surgery coveted the most citations ( n =520). Related topics of frontiers will still focus on congenital heart disease, valvular heart disease, and left atrial appendage closure. CONCLUSIONS The authors summarized the publication information of the application of 3D printing in cardiovascular diseases related literature from 2000 to 2023, including country and institution of origin, authors, and publication journal. This study can reflect the current hotspots and novel directions for the application of 3D printing in cardiovascular diseases.
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Affiliation(s)
- Xin Zhang
- The First School of Clinical Medicine of Gansu University of Chinese Medicine
- Gansu International Scientific and Technological Cooperation Base of Diagnosis and Treatment of Congenital Heart Disease
| | - Kang Yi
- Gansu International Scientific and Technological Cooperation Base of Diagnosis and Treatment of Congenital Heart Disease
- Department of Cardiovascular Surgery, Gansu Provincial Hospital
| | - Jian-Guo Xu
- Evidence-Based Medicine Center, School of BasicMedical Sciences, Lanzhou University
| | - Wen-Xin Wang
- The First School of Clinical Medicine of Gansu University of Chinese Medicine
- Gansu International Scientific and Technological Cooperation Base of Diagnosis and Treatment of Congenital Heart Disease
| | - Cheng-Fei Liu
- Gansu International Scientific and Technological Cooperation Base of Diagnosis and Treatment of Congenital Heart Disease
- The First Clinical Medical College of Lanzhou University, Lanzhou, People's Republic of China
| | - Xiao-Long He
- The First School of Clinical Medicine of Gansu University of Chinese Medicine
- Gansu International Scientific and Technological Cooperation Base of Diagnosis and Treatment of Congenital Heart Disease
| | - Fan-Ning Wang
- The First School of Clinical Medicine of Gansu University of Chinese Medicine
- Gansu International Scientific and Technological Cooperation Base of Diagnosis and Treatment of Congenital Heart Disease
| | - Guo-Lei Zhou
- Gansu International Scientific and Technological Cooperation Base of Diagnosis and Treatment of Congenital Heart Disease
- Department of Cardiovascular Surgery, Gansu Provincial Hospital
| | - Tao You
- Gansu International Scientific and Technological Cooperation Base of Diagnosis and Treatment of Congenital Heart Disease
- Department of Cardiovascular Surgery, Gansu Provincial Hospital
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14
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Tsai AY, Greene AC. 3D printing in pediatric surgery. Semin Pediatr Surg 2024; 33:151385. [PMID: 38242062 DOI: 10.1016/j.sempedsurg.2024.151385] [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] [Indexed: 01/21/2024]
Abstract
Pediatric surgery presents a unique challenge, requiring a specialized approach due to the intricacies of compact anatomy and the presence of distinct congenital features in young patients. Surgeons are tasked with making decisions that not only address immediate concerns but also consider the evolving needs of children as they grow. The advent of three-dimensional (3D) printing has emerged as a valuable tool to facilitate a personalized medical approach. This paper starts by outlining the basics of 3D modeling and printing. We then delve into the transformative role of 3D printing in pediatric surgery, elucidating its applications, benefits, and challenges. The paper concludes by envisioning the future prospects of 3D printing, foreseeing advancements in personalized treatment approaches, improved patient outcomes, and the continued evolution of this technology as an indispensable asset in the pediatric surgical arena.
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Affiliation(s)
- Anthony Y Tsai
- Division of Pediatric Surgery, Assistant Professor of Surgery and Pediatrics, Penn State Children's Hospital, 500 University Drive, Hershey, PA 17033, United States.
| | - Alicia C Greene
- Division of Pediatric Surgery, Assistant Professor of Surgery and Pediatrics, Penn State Children's Hospital, 500 University Drive, Hershey, PA 17033, United States
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15
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Iqbal H, Fernandes Q, Idoudi S, Basineni R, Billa N. Status of Polymer Fused Deposition Modeling (FDM)-Based Three-Dimensional Printing (3DP) in the Pharmaceutical Industry. Polymers (Basel) 2024; 16:386. [PMID: 38337275 DOI: 10.3390/polym16030386] [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: 12/17/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Additive manufacturing (AM) or 3D printing (3DP) is arguably a versatile and more efficient way for the production of solid dosage forms such as tablets. Of the various 3DP technologies currently available, fused deposition modeling (FDM) includes unique characteristics that offer a range of options in the production of various types of tablets. For example, amorphous solid dispersions (ASDs), enteric-coated tablets or poly pills can be produced using an appropriate drug/polymer combination during FDM 3DP. The technology offers the possibility of evolving personalized medicines into cost-effective production schemes at pharmacies and hospital dispensaries. In this review, we highlight key FDM features that may be exploited for the production of tablets and improvement of therapy, with emphasis on gastrointestinal delivery. We also highlight current constraints that must be surmounted to visualize the deployment of this technology in the pharmaceutical and healthcare industries.
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Affiliation(s)
- Heba Iqbal
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Queenie Fernandes
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Sourour Idoudi
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Renuka Basineni
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Nashiru Billa
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
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16
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Odemis E, AKA İB, Ali MHA, Gumus T, Pekkan K. Optimizing percutaneous pulmonary valve implantation with patient-specific 3D-printed pulmonary artery models and hemodynamic assessment. Front Cardiovasc Med 2024; 10:1331206. [PMID: 38259310 PMCID: PMC10800937 DOI: 10.3389/fcvm.2023.1331206] [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: 10/31/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Background Percutaneous pulmonary valve implantation (PPVI) has emerged as a less invasive alternative for treating severe pulmonary regurgitation after tetralogy of Fallot (TOF) repair in patients with a native right ventricular outflow tract (RVOT). However, the success of PPVI depends on precise patient-specific valve sizing, the avoidance of oversizing complications, and optimal valve performance. In recent years, innovative adaptations of commercially available cardiovascular mock loops have been used to test conduits in the pulmonary position. These models are instrumental in facilitating accurate pulmonic valve sizing, mitigating the risk of oversizing, and providing insight into the valve performance before implantation. This study explored the utilization of custom-modified mock loops to implant patient-specific 3D-printed pulmonary artery geometries, thereby advancing PPVI planning and execution. Material and Methods Patient-specific 3D-printed pulmonary artery geometries of five patients who underwent PPVI using Pulsta transcatheter heart valve (THV) ® were tested in a modified ViVitro pulse duplicator system®. Various valve sizes were subjected to 10 cycles of testing at different cardiac output levels. The transpulmonary systolic and regurgitation fractions of the valves were also recorded and compared. Results A total of 39 experiments were conducted using five different patient geometries and several different valve sizes (26, 28, 30, and 32 mm) at 3, 4, and 5 L/min cardiac output at heart rates of 70 beats per minute (bpm) and 60/40 systolic/diastolic ratios. The pressure gradients and regurgitation fractions of the tested valve sizes in the models were found to be similar to the pressure gradients and regurgitation fractions of valves used in real procedures. However, in two patients, different valve sizes showed better hemodynamic values than the actual implanted valves. Discussion The use of 3D printing technology, electromagnetic flow meters, and the custom-modified ViVitro pulse duplicator system® in conjunction with patient-specific pulmonary artery models has enabled a comprehensive assessment of percutaneous pulmonic valve implantation performance. This approach allows for accurate valve sizing, minimization of oversizing risks, and valuable insights into hemodynamic behavior before implantation. The data obtained from this experimental setup will contribute to advancing PPVI procedures and offer potential benefits in improving patient outcomes and safety.
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Affiliation(s)
- Ender Odemis
- Congenital Heart Disease Research Laboratory, Kuttam, Koç University Hospital, Istanbul, Türkiye
- Department of Pediatric Cardiology, Faculty of Medicine, Koç University, Istanbul, Türkiye
| | - İbrahim Basar AKA
- Department of Mechatronics Engineering, Faculty of Engineering and Natural Sciences, İstanbul Bilgi University, Istanbul, Türkiye
| | - Mhd Homam Alhaj Ali
- Biomedical Engineering, Faculty of Engineering and Natural Sciences, İstanbul Medipol University, Istanbul, Türkiye
| | - Terman Gumus
- Department of Radiology, Faculty of Medicine, Koç University, Istanbul, Türkiye
| | - Kerem Pekkan
- Department of Mechanical Engineering, Faculty of Engineering, Koç University, Istanbul, Türkiye
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17
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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.
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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.
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18
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Stieger-Vanegas SM, Scollan KF. Development of three-dimensional (3D) cardiac models from computed tomography angiography. J Vet Cardiol 2023; 51:195-206. [PMID: 38198977 DOI: 10.1016/j.jvc.2023.11.017] [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: 01/15/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 01/12/2024]
Abstract
Three-dimensional (3D) modeling and printing is an emerging technology in veterinary cardiovascular medicine allowing the fabrication of anatomically correct patient-specific models. These patient-specific models can be used for a wide range of purposes including medical teaching, assessment of cardiac function and movement of valve leaflets, design and assessment of devices created for interventional procedures, and pre-surgical planning [1-3]. Additionally, these 3D models can facilitate communication between the clinical team and the patient's owner. The process of creating 3D models starts with acquiring volumetric imaging data sets of the area of interest. Three-dimensional modeling and printing are reliable when high-quality volumetric imaging data are used to create these models. Currently, only ungated- and electrocardiogram (ECG)-gated computed tomography (CT), cardiac magnetic resonance imaging (CMRI), and 3D echocardiography provide the volumetric data sets needed to create these 3D models. These imaging data sets are imported into a software or open-source freeware platform and then segmented to create a virtual 3D model. This virtual 3D model can be further refined using computer-aided design (CAD) software and then be printed to create a physical 3D model. Cardiovascular 3D modeling and printing is a new medical tool which allows us to expand the way we plan interventional procedures, practice interventional skills, communicate with the medical team and owner, and teach future veterinarians.
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Affiliation(s)
- S M Stieger-Vanegas
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA.
| | - K F Scollan
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA
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Karsenty C, Hadeed K, Pyra P, Guitarte A, Djeddai C, Vincent R, Dulac Y, Silagdze I, Gobin J, Combes N, Ratsimandresy M, Berthomieu L, Calvaruso D, Acar P. Advancing paediatric cardiac imaging: a comprehensive analysis of the feasibility and accuracy of a novel 3D paediatric transoesophageal probe. Front Cardiovasc Med 2023; 10:1294109. [PMID: 38116539 PMCID: PMC10728472 DOI: 10.3389/fcvm.2023.1294109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/13/2023] [Indexed: 12/21/2023] Open
Abstract
Aims Pediatric transoesophageal echocardiography (TOE) probes have remained two-dimensional (2D) limiting their use compared to adults. While critical in pediatrics for interventions and post-surgery assessments, technological advancements introduced a three-dimensional (3D) pediatric TOE probe. This study assessed the new 3D pediatric TOE probe (GE 9VT-D) for feasibility, handling, and imaging quality. Methods and results At Children's Hospital of Toulouse, 2-month prospective study enrolled children undergoing TOE with the new probe. All imaging modalities were rated by 2 operators using a 5-point Likert-type scale from 1 (very poor) to 5 (very good) quality. Forty-five children, median age 3.7 (range: 2 months-14.7 years) median weight 7.8 kg (range: 4.3-48 kg) underwent 60 TOEs: 25% pre-surgery, 45% post-surgery, 28% during percutaneous procedures, and 2% in intensive care. Probe handling was "very easy" in all cases without adverse events. The median score of 2D, 2D colour, pulsed Doppler and 3D were noted 5 out of 5 and continuous Doppler and 3D colour 4 out of 5. The 3D image quality remained consistent irrespective of the patient weighing above or below 7.8 kg (p = 0.72). Postoperative TOEs identified two cases needing further interventions, emphasizing its value in evaluating surgical outcomes and also for guiding percutaneous interventions. Conclusion Our comprehensive evaluation demonstrates that the new 3D pediatric TOE probe is feasible and provides high-quality imaging in pediatric patients. The successful integration of this novel probe into clinical practice has the potential to enhance diagnostic accuracy and procedural planning, ultimately optimizing patient outcomes in pediatric cardiac care.
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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, Toulouse, France
| | - Khaled Hadeed
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Pierrick Pyra
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Aitor Guitarte
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Camelia Djeddai
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Remi Vincent
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Yves Dulac
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Ia Silagdze
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Julie Gobin
- Department of Anesthesiology and Paediatric Cardiology, University Hospital, Toulouse, France
| | - Nicolas Combes
- Department of Cardiology, Clinique Pasteur [Pasteur Clinic], Toulouse, France
| | | | - Lionel Berthomieu
- Department of Intensive Care Unit and Paediatric Cardiology, University Hospital, Toulouse, France
| | - Davide Calvaruso
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Philippe Acar
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
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20
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Mohanadas HP, Nair V, Doctor AA, Faudzi AAM, Tucker N, Ismail AF, Ramakrishna S, Saidin S, Jaganathan SK. A Systematic Analysis of Additive Manufacturing Techniques in the Bioengineering of In Vitro Cardiovascular Models. Ann Biomed Eng 2023; 51:2365-2383. [PMID: 37466879 PMCID: PMC10598155 DOI: 10.1007/s10439-023-03322-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
Additive Manufacturing is noted for ease of product customization and short production run cost-effectiveness. As our global population approaches 8 billion, additive manufacturing has a future in maintaining and improving average human life expectancy for the same reasons that it has advantaged general manufacturing. In recent years, additive manufacturing has been applied to tissue engineering, regenerative medicine, and drug delivery. Additive Manufacturing combined with tissue engineering and biocompatibility studies offers future opportunities for various complex cardiovascular implants and surgeries. This paper is a comprehensive overview of current technological advancements in additive manufacturing with potential for cardiovascular application. The current limitations and prospects of the technology for cardiovascular applications are explored and evaluated.
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Affiliation(s)
| | - Vivek Nair
- Computational Fluid Dynamics (CFD) Lab, Mechanical and Aerospace Engineering, University of Texas Arlington, Arlington, TX, 76010, USA
| | | | - Ahmad Athif Mohd Faudzi
- Faculty of Engineering, School of Electrical Engineering, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
- Centre for Artificial Intelligence and Robotics, Universiti Teknologi Malaysia, Kuala Lumpur, Malaysia
| | - Nick Tucker
- School of Engineering, College of Science, Brayford Pool, Lincoln, LN6 7TS, UK
| | - Ahmad Fauzi Ismail
- School of Chemical and Energy Engineering, Advanced Membrane Technology Research Centre (AMTEC), Universiti Teknologi Malaysia, Skudai, Malaysia
| | - Seeram Ramakrishna
- Department of Mechanical Engineering, Center for Nanofibers & Nanotechnology Initiative, National University of Singapore, Singapore, Singapore
| | - Syafiqah Saidin
- IJNUTM Cardiovascular Engineering Centre, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
| | - Saravana Kumar Jaganathan
- Faculty of Engineering, School of Electrical Engineering, Universiti Teknologi Malaysia, Johor Bahru, Malaysia.
- Centre for Artificial Intelligence and Robotics, Universiti Teknologi Malaysia, Kuala Lumpur, Malaysia.
- School of Engineering, College of Science, Brayford Pool, Lincoln, LN6 7TS, UK.
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21
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Karsenty C, Alattar Y, Mousseaux E, Marcilhacy G, Gencer U, Craiem D, Iserin L, Ladouceur M, Legendre A, Laredo M, Bonnet D, Malekzadeh-Milani S, Soulat G. 4D flow magnetic resonance imaging to assess right ventricular outflow tract in patients undergoing transcatheter pulmonary valve replacement. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2023; 76:793-802. [PMID: 36921915 DOI: 10.1016/j.rec.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/22/2023] [Indexed: 03/14/2023]
Abstract
INTRODUCTION AND OBJECTIVES Magnetic resonance imaging (MRI) including 4D flow is used before percutaneous pulmonary valve implantation (PPVI). As PPVI is limited by the size of the right ventricular outflow tract (RVOT), accurate sizing is needed to plan the intervention. The aim of this study was to compare different MRI modalities and invasive angiography to balloon sizing of RVOT. METHODS Single-center prospective study of patients who underwent PPVI for isolated pulmonary regurgitation assessed by 4D flow MRI, 3D steady-state free precession/gradient echo (3D SSFP/GRE) and contrast magnetic resonance angiography. Balloon sizing was considered as the reference. RESULTS A total of 23 adults were included (mean age, 38.4±12.5 years). Eighteen patients underwent successful primary PPVI. The average of the narrowest RVOT diameter was 25.4±4.3 mm by balloon sizing. Compared to balloon sizing, RVOT diameters were better correlated when estimated by systolic 4D flow MRI (r=0.89, P<.001) than by diastolic 4D flow MRI (r=0.71, P <.001), 3D contrast magnetic resonance angiography (r=0.73; P <.001) and 3D SSFP/GRE (r=0.50; P=.04) and was not significantly correlated when estimated by 2D in diastole and systole. The mean difference between systolic 4D flow MRI and balloon sizing was 0.2 mm (95%CI, -3.5 to 3.9 mm), whereas it was wider with other techniques. CONCLUSIONS Beyond the quantification of pulmonary valve regurgitation, 4D flow allows accurate estimation of RVOT diameters, especially in systole, which is fundamental before planning PPVI.
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Affiliation(s)
- Clément Karsenty
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Pediatric and Congenital Cardiology, Children's Hospital, CHU Toulouse, Toulouse, France; Institut des Maladies Métaboliques et Cardiovasculaires, Université de Toulouse, Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Toulouse, France; Adult Congenital Cardiology Department, Clinique Pasteur, Toulouse, France.
| | - Yousef Alattar
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Elie Mousseaux
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Paris Centre de Recherche Cardiovasculaire (PARCC), Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) Paris, France
| | - Gabrielle Marcilhacy
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Umit Gencer
- Paris Centre de Recherche Cardiovasculaire (PARCC), Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) Paris, France
| | - Damian Craiem
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Laurence Iserin
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Magalie Ladouceur
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Paris Centre de Recherche Cardiovasculaire (PARCC), Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) Paris, France
| | - Antoine Legendre
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Mikael Laredo
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Institut de Cardiologie, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Damien Bonnet
- Pediatric and Congenital Department, M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Paris, France; Institut IMAGINE, Université de Paris, Paris, France
| | - Sophie Malekzadeh-Milani
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Pediatric and Congenital Department, M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Paris, France
| | - Gilles Soulat
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Paris Centre de Recherche Cardiovasculaire (PARCC), Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) Paris, France
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Antonuccio MN, Gasparotti E, Bardi F, Monteleone A, This A, Rouet L, Avril S, Celi S. Fabrication of deformable patient-specific AAA models by material casting techniques. Front Cardiovasc Med 2023; 10:1141623. [PMID: 37753165 PMCID: PMC10518418 DOI: 10.3389/fcvm.2023.1141623] [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: 01/10/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
Background Abdominal Aortic Aneurysm (AAA) is a balloon-like dilatation that can be life-threatening if not treated. Fabricating patient-specific AAA models can be beneficial for in-vitro investigations of hemodynamics, as well as for pre-surgical planning and training, testing the effectiveness of different interventions, or developing new surgical procedures. The current direct additive manufacturing techniques cannot simultaneously ensure the flexibility and transparency of models required by some applications. Therefore, casting techniques are presented to overcome these limitations and make the manufactured models suitable for in-vitro hemodynamic investigations, such as particle image velocimetry (PIV) measurements or medical imaging. Methods Two complex patient-specific AAA geometries were considered, and the related 3D models were fabricated through material casting. In particular, two casting approaches, i.e. lost molds and lost core casting, were investigated and tested to manufacture the deformable AAA models. The manufactured models were acquired by magnetic resonance, computed tomography (CT), ultrasound imaging, and PIV. In particular, CT scans were segmented to generate a volumetric reconstruction for each manufactured model that was compared to a reference model to assess the accuracy of the manufacturing process. Results Both lost molds and lost core casting techniques were successful in the manufacturing of the models. The lost molds casting allowed a high-level surface finish in the final 3D model. In this first case, the average signed distance between the manufactured model and the reference was (- 0.2 ± 0.2 ) mm. However, this approach was more expensive and time-consuming. On the other hand, the lost core casting was more affordable and allowed the reuse of the external molds to fabricate multiple copies of the same AAA model. In this second case, the average signed distance between the manufactured model and the reference was (0.1 ± 0.6 ) mm. However, the final model's surface finish quality was poorer compared to the model obtained by lost molds casting as the sealing of the outer molds was not as firm as the other casting technique. Conclusions Both lost molds and lost core casting techniques can be used for manufacturing patient-specific deformable AAA models suitable for hemodynamic investigations, including medical imaging and PIV.
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Affiliation(s)
- Maria Nicole Antonuccio
- BioCardioLab, Bioengineering Unit - Heart Hospital, Fondazione Toscana “G. Monasterio”, Massa, Italy
- Philips Research Paris, Suresnes, France
- Mines Saint-Étienne, Université Jean Monnet, INSERM, Saint-Étienne, France
| | - Emanuele Gasparotti
- BioCardioLab, Bioengineering Unit - Heart Hospital, Fondazione Toscana “G. Monasterio”, Massa, Italy
| | - Francesco Bardi
- BioCardioLab, Bioengineering Unit - Heart Hospital, Fondazione Toscana “G. Monasterio”, Massa, Italy
- Mines Saint-Étienne, Université Jean Monnet, INSERM, Saint-Étienne, France
- Predisurge, Grande Usine Creative 2, Saint-Etienne, France
| | - Angelo Monteleone
- Department of Radiology, Fondazione Toscana “G. Monasterio”, Massa, Italy
| | | | | | - Stéphane Avril
- Mines Saint-Étienne, Université Jean Monnet, INSERM, Saint-Étienne, France
| | - Simona Celi
- BioCardioLab, Bioengineering Unit - Heart Hospital, Fondazione Toscana “G. Monasterio”, Massa, Italy
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23
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Bharucha AH, Moore J, Carnahan P, MacCarthy P, Monaghan MJ, Baghai M, Deshpande R, Byrne J, Dworakowski R, Eskandari M. Three-dimensional printing in modelling mitral valve interventions. Echo Res Pract 2023; 10:12. [PMID: 37528494 PMCID: PMC10394816 DOI: 10.1186/s44156-023-00024-x] [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: 01/26/2023] [Accepted: 06/23/2023] [Indexed: 08/03/2023] Open
Abstract
Mitral interventions remain technically challenging owing to the anatomical complexity and heterogeneity of mitral pathologies. As such, multi-disciplinary pre-procedural planning assisted by advanced cardiac imaging is pivotal to successful outcomes. Modern imaging techniques offer accurate 3D renderings of cardiac anatomy; however, users are required to derive a spatial understanding of complex mitral pathologies from a 2D projection thus generating an 'imaging gap' which limits procedural planning. Physical mitral modelling using 3D printing has the potential to bridge this gap and is increasingly being employed in conjunction with other transformative technologies to assess feasibility of intervention, direct prosthesis choice and avoid complications. Such platforms have also shown value in training and patient education. Despite important limitations, the pace of innovation and synergistic integration with other technologies is likely to ensure that 3D printing assumes a central role in the journey towards delivering personalised care for patients undergoing mitral valve interventions.
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Affiliation(s)
- Apurva H Bharucha
- The Cardiac Care Group, King's College Hospital, London, SE5 9RS, UK
| | - John Moore
- Robarts Research Institute, Western University, London, ON, Canada
| | - Patrick Carnahan
- Robarts Research Institute, Western University, London, ON, Canada
| | - Philip MacCarthy
- The Cardiac Care Group, King's College Hospital, London, SE5 9RS, UK
| | - Mark J Monaghan
- The Cardiac Care Group, King's College Hospital, London, SE5 9RS, UK
| | - Max Baghai
- The Cardiac Care Group, King's College Hospital, London, SE5 9RS, UK
| | - Ranjit Deshpande
- The Cardiac Care Group, King's College Hospital, London, SE5 9RS, UK
| | - Jonathan Byrne
- The Cardiac Care Group, King's College Hospital, London, SE5 9RS, UK
| | - Rafal Dworakowski
- The Cardiac Care Group, King's College Hospital, London, SE5 9RS, UK
| | - Mehdi Eskandari
- The Cardiac Care Group, King's College Hospital, London, SE5 9RS, UK.
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Buote NJ, Porter I, Dakin GF. 3D printed cannulas for use in laparoscopic surgery in feline patients: A cadaveric study and case series. Vet Surg 2023; 52:870-877. [PMID: 35815791 DOI: 10.1111/vsu.13849] [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: 02/07/2022] [Revised: 04/23/2022] [Accepted: 05/05/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate custom 3D printed laparoscopic cannulas (3DPC) in a feline cadaveric abdominal surgery model and report their use in two live feline subjects. STUDY DESIGN Experimental cadaver study, live subject case series. ANIMALS Ten feline cadavers; two feline subjects. METHODS Custom 3DPCs were initially modeled in a PLA filament material and then created in an autoclavable dental resin for use in live patients. The surgery time, number of surgical collisions and cannula complications were recorded during cadaver procedures before and after use of 3DPCs. Cannula complications were recorded during live procedures and patients were followed to suture removal to record any incisional complications. RESULTS There was a significant reduction in mean surgical time (125.6 vs. 95.2 min, p = 0.03), mean number of instrument collisions (6.8 vs. 2.6, p = 0.03), and mean number of cannula complications (10 vs. 2.2, p = 0.03) with the use of only 3DPCs during the procedure. During the live procedures the use of the 3DPCs was successful and no postoperative complications occurred at the incision sites. CONCLUSION The use of customized 3DPCs may improve surgical dexterity and decrease complications in advanced procedures and was not associated with any clinical complications in two cats. The use of 3DPCs in veterinary medicine may allow for wider practice of laparoscopic techniques in small animals.
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Affiliation(s)
- Nicole J Buote
- Department of Clinical Sciences, Soft Tissue Surgery, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Ian Porter
- Department of Clinical Sciences, Diagnostic Imaging, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Gregory F Dakin
- Department of Bariatric Surgery, Weill Cornell Medical College, New York, New York City, USA
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Sun Z, Zhao J, Leung E, Flandes-Iparraguirre M, Vernon M, Silberstein J, De-Juan-Pardo EM, Jansen S. Three-Dimensional Bioprinting in Cardiovascular Disease: Current Status and Future Directions. Biomolecules 2023; 13:1180. [PMID: 37627245 PMCID: PMC10452258 DOI: 10.3390/biom13081180] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
Three-dimensional (3D) printing plays an important role in cardiovascular disease through the use of personalised models that replicate the normal anatomy and its pathology with high accuracy and reliability. While 3D printed heart and vascular models have been shown to improve medical education, preoperative planning and simulation of cardiac procedures, as well as to enhance communication with patients, 3D bioprinting represents a potential advancement of 3D printing technology by allowing the printing of cellular or biological components, functional tissues and organs that can be used in a variety of applications in cardiovascular disease. Recent advances in bioprinting technology have shown the ability to support vascularisation of large-scale constructs with enhanced biocompatibility and structural stability, thus creating opportunities to replace damaged tissues or organs. In this review, we provide an overview of the use of 3D bioprinting in cardiovascular disease with a focus on technologies and applications in cardiac tissues, vascular constructs and grafts, heart valves and myocardium. Limitations and future research directions are highlighted.
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Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6102, Australia;
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA 6102, Australia
| | - Jack Zhao
- School of Medicine, Faculty of Health Sciences, The University of Western Australia, Perth, WA 6009, Australia; (J.Z.); (E.L.)
| | - Emily Leung
- School of Medicine, Faculty of Health Sciences, The University of Western Australia, Perth, WA 6009, Australia; (J.Z.); (E.L.)
| | - Maria Flandes-Iparraguirre
- Regenerative Medicine Program, Cima Universidad de Navarra, 31008 Pamplona, Spain;
- T3mPLATE, Harry Perkins Institute of Medical Research, QEII Medical Centre and UWA Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia; (M.V.); (E.M.D.-J.-P.)
- School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Michael Vernon
- T3mPLATE, Harry Perkins Institute of Medical Research, QEII Medical Centre and UWA Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia; (M.V.); (E.M.D.-J.-P.)
- School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
- Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre and UWA Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia
| | - Jenna Silberstein
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6102, Australia;
| | - Elena M. De-Juan-Pardo
- T3mPLATE, Harry Perkins Institute of Medical Research, QEII Medical Centre and UWA Centre for Medical Research, The University of Western Australia, Perth, WA 6009, Australia; (M.V.); (E.M.D.-J.-P.)
- School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia;
| | - Shirley Jansen
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia;
- Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Perth, WA 6009, Australia
- Heart and Vascular Research Institute, Harry Perkins Medical Research Institute, Perth, WA 6009, Australia
- School of Medicine, The University of Western Australia, Perth, WA 6009, Australia
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26
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Youn JK, Park HS, Ko D, Yang HB, Kim HY, Yoon HB. Application of additional three-dimensional materials for education in pediatric anatomy. Sci Rep 2023; 13:9973. [PMID: 37340064 DOI: 10.1038/s41598-023-36912-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 06/12/2023] [Indexed: 06/22/2023] Open
Abstract
We conducted this study to investigate the effects of additional education using 3D visualization (3DV) and 3D printing (3DP) after applying 2D images for anatomical education in normal pediatric structures and congenital anomalies. For the production of 3DV and 3DP of the anatomical structures, computed tomography (CT) images of the four topics (the normal upper/lower abdomen, choledochal cyst, and imperforate anus) were used. Anatomical self-education and tests were administered to a total of 15 third-year medical students with these modules. Following the tests, surveys were conducted in order to evaluate satisfaction from students. In all four topics, there were significant increases in the test results with additional education with 3DV after initial self-study with CT (P < 0.05). The difference in scores was highest for the imperforate anus when 3DV supplemented the self-education. In the survey on the teaching modules, the overall satisfaction scores for 3DV and 3DP were 4.3 and 4.0 out of 5, respectively. When 3DV was added to pediatric abdominal anatomical education, we found an enhancement in understanding of normal structures and congenital anomalies. We can expect the application of 3D materials to become more widely used in anatomical education in various fields.
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Affiliation(s)
- Joong Kee Youn
- Department of Pediatric Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Pediatric Surgery, Seoul National University College of Medicine, 101 Daehak-Ro, Jongro-Gu, Seoul, 03080, Korea
| | - Han Sang Park
- Department of Pediatric Surgery, Seoul National University Hospital, Seoul, Korea
| | - Dayoung Ko
- Department of Pediatric Surgery, Seoul National University Hospital, Seoul, Korea
| | - Hee-Beom Yang
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Gyounggi, Korea
| | - Hyun-Young Kim
- Department of Pediatric Surgery, Seoul National University Hospital, Seoul, Korea.
- Department of Pediatric Surgery, Seoul National University College of Medicine, 101 Daehak-Ro, Jongro-Gu, Seoul, 03080, Korea.
| | - Hyun Bae Yoon
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea
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27
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Al-Nimry SS, Daghmash RM. Three Dimensional Printing and Its Applications Focusing on Microneedles for Drug Delivery. Pharmaceutics 2023; 15:1597. [PMID: 37376046 DOI: 10.3390/pharmaceutics15061597] [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: 04/12/2023] [Revised: 05/08/2023] [Accepted: 05/16/2023] [Indexed: 06/29/2023] Open
Abstract
Microneedles (MNs) are considered to be a novel smart injection system that causes significantly low skin invasion upon puncturing, due to the micron-sized dimensions that pierce into the skin painlessly. This allows transdermal delivery of numerous therapeutic molecules, such as insulin and vaccines. The fabrication of MNs is carried out through conventional old methods such as molding, as well as through newer and more sophisticated technologies, such as three-dimensional (3D) printing, which is considered to be a superior, more accurate, and more time- and production-efficient method than conventional methods. Three-dimensional printing is becoming an innovative method that is used in education through building intricate models, as well as being employed in the synthesis of fabrics, medical devices, medical implants, and orthoses/prostheses. Moreover, it has revolutionary applications in the pharmaceutical, cosmeceutical, and medical fields. Having the capacity to design patient-tailored devices according to their dimensions, along with specified dosage forms, has allowed 3D printing to stand out in the medical field. The different techniques of 3D printing allow for the production of many types of needles with different materials, such as hollow MNs and solid MNs. This review covers the benefits and drawbacks of 3D printing, methods used in 3D printing, types of 3D-printed MNs, characterization of 3D-printed MNs, general applications of 3D printing, and transdermal delivery using 3D-printed MNs.
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Affiliation(s)
- Suhair S Al-Nimry
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Rawand M Daghmash
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
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Cai H, Xu X, Lu X, Zhao M, Jia Q, Jiang HB, Kwon JS. Dental Materials Applied to 3D and 4D Printing Technologies: A Review. Polymers (Basel) 2023; 15:polym15102405. [PMID: 37242980 DOI: 10.3390/polym15102405] [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: 04/23/2023] [Revised: 05/09/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
As computer-aided design and computer-aided manufacturing (CAD/CAM) technologies have matured, three-dimensional (3D) printing materials suitable for dentistry have attracted considerable research interest, owing to their high efficiency and low cost for clinical treatment. Three-dimensional printing technology, also known as additive manufacturing, has developed rapidly over the last forty years, with gradual application in various fields from industry to dental sciences. Four-dimensional (4D) printing, defined as the fabrication of complex spontaneous structures that change over time in response to external stimuli in expected ways, includes the increasingly popular bioprinting. Existing 3D printing materials have varied characteristics and scopes of application; therefore, categorization is required. This review aims to classify, summarize, and discuss dental materials for 3D printing and 4D printing from a clinical perspective. Based on these, this review describes four major materials, i.e., polymers, metals, ceramics, and biomaterials. The manufacturing process of 3D printing and 4D printing materials, their characteristics, applicable printing technologies, and clinical application scope are described in detail. Furthermore, the development of composite materials for 3D printing is the main focus of future research, as combining multiple materials can improve the materials' properties. Updates in material sciences play important roles in dentistry; hence, the emergence of newer materials are expected to promote further innovations in dentistry.
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Affiliation(s)
- HongXin Cai
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul 03722, Republic of Korea
| | - Xiaotong Xu
- The CONVERSATIONALIST Club, School of Stomatology, Shandong First Medical University, Jinan 250117, China
| | - Xinyue Lu
- The CONVERSATIONALIST Club, School of Stomatology, Shandong First Medical University, Jinan 250117, China
| | - Menghua Zhao
- The CONVERSATIONALIST Club, School of Stomatology, Shandong First Medical University, Jinan 250117, China
| | - Qi Jia
- The CONVERSATIONALIST Club, School of Stomatology, Shandong First Medical University, Jinan 250117, China
| | - Heng-Bo Jiang
- The CONVERSATIONALIST Club, School of Stomatology, Shandong First Medical University, Jinan 250117, China
| | - Jae-Sung Kwon
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul 03722, Republic of Korea
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29
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de Oliveira Laterza Ribeiro M, Correia VM, Herling de Oliveira LL, Soares PR, Scudeler TL. Evolving Diagnostic and Management Advances in Coronary Heart Disease. Life (Basel) 2023; 13:951. [PMID: 37109480 PMCID: PMC10143565 DOI: 10.3390/life13040951] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/02/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
Despite considerable improvement in diagnostic modalities and therapeutic options over the last few decades, the global burden of ischemic heart disease is steadily rising, remaining a major cause of death worldwide. Thus, new strategies are needed to lessen cardiovascular events. Researchers in different areas such as biotechnology and tissue engineering have developed novel therapeutic strategies such as stem cells, nanotechnology, and robotic surgery, among others (3D printing and drugs). In addition, advances in bioengineering have led to the emergence of new diagnostic and prognostic techniques, such as quantitative flow ratio (QFR), and biomarkers for atherosclerosis. In this review, we explore novel diagnostic invasive and noninvasive modalities that allow a more detailed characterization of coronary disease. We delve into new technological revascularization procedures and pharmacological agents that target several residual cardiovascular risks, including inflammatory, thrombotic, and metabolic pathways.
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Affiliation(s)
| | | | | | | | - Thiago Luis Scudeler
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-010, Brazil
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30
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Yahiro DS, Abrantes JCDS, Magliano DC, Mesquita CT. Criação de Modelos Embriológicos Cardíacos para Impressão 3D para Ensino de Anatomia e Embriologia. Arq Bras Cardiol 2023; 120:e20220632. [PMID: 37098991 PMCID: PMC10124573 DOI: 10.36660/abc.20220632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/14/2022] [Indexed: 04/08/2023] Open
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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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Mao Y, Liu Y, Zhai M, Yang J. Application of and Prospects for 3-Dimensional Printing in Transcatheter Mitral Valve Interventions. Rev Cardiovasc Med 2023; 24:61. [PMID: 39077424 PMCID: PMC11273148 DOI: 10.31083/j.rcm2402061] [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: 08/19/2022] [Revised: 09/19/2022] [Accepted: 09/27/2022] [Indexed: 07/31/2024] Open
Abstract
Mitral valve (MV) disease is one of the most common valvular diseases that endangers health status. A variety of catheter-based interventions have been developed to treat MV disease. The special anatomical structures of the MV complex increase the difficulty of interventional surgery, and the incidence of perioperative complications remains high. With the continuous development of cardiovascular 3-dimensional (3D) printing technology and of multidisciplinary cooperation, 3D printing for transcatheter mitral valve interventions (TMVI) has become a revolutionary technology to promote innovation and improve the success rate. Patient-specific 3D printed models have been used in measuring sizes and predicting perioperative complications before TMVI. By simulating a bench test and using multi-material printing, surgeons may learn how the device interacts with the specific anatomical structures of the MV. This review summarizes relevant cutting-edge publications in this field and illustrates the application of 3D printing in TMVI with examples. In addition, we discuss the limitations and future directions of 3D printing in TMVI. Clinical Trial Registration ClinicalTrials.gov Protocol Registration System (NCT02917980).
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Affiliation(s)
- Yu Mao
- Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, 710032 Xi'an, Shaanxi, China
| | - Yang Liu
- Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, 710032 Xi'an, Shaanxi, China
| | - Mengen Zhai
- Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, 710032 Xi'an, Shaanxi, China
| | - Jian Yang
- Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, 710032 Xi'an, Shaanxi, 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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Carmon P, Fleming GA, Barker PCA, Sturgeon GM, Turek JW, Chamberlain RC. Whole-Chest Three-Dimensional Modeling Aids Hybrid Pulmonary Valve Replacement Following Double Switch Operation. World J Pediatr Congenit Heart Surg 2023; 14:95-97. [PMID: 36266955 DOI: 10.1177/21501351221132161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The double switch operation for congenitally corrected transposition of the great arteries (CC-TGA) has been associated with high rates of reintervention, including the need for pulmonary valve replacement. Hybrid interventional approaches can avoid bypass when complex anatomy complicates traditional catheter-based approaches. We present a case of successful transcatheter pulmonary valve replacement via hybrid per-ventricular approach with pre-procedural planning aided by 3D segmentation of skeletal and cardiac anatomy in a patient with surgically corrected CC-GTA.
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Affiliation(s)
- Philip Carmon
- Department of Pediatrics, 609772Duke University Medical Center, Durham, NC, USA
| | - Gregory A Fleming
- Department of Pediatrics, 609772Duke University Medical Center, Durham, NC, USA
| | - Piers C A Barker
- Department of Pediatrics, 609772Duke University Medical Center, Durham, NC, USA
| | - Gregory M Sturgeon
- Department of Pediatrics, 609772Duke University Medical Center, Durham, NC, USA
| | - Joseph W Turek
- Department of Surgery, 609772Duke University Medical Center, Durham, NC, USA
| | - Reid C Chamberlain
- Department of Pediatrics, 609772Duke University Medical Center, Durham, NC, USA
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Clough JR, Byrne N, Oksuz I, Zimmer VA, Schnabel JA, King AP. A Topological Loss Function for Deep-Learning Based Image Segmentation Using Persistent Homology. IEEE TRANSACTIONS ON PATTERN ANALYSIS AND MACHINE INTELLIGENCE 2022; 44:8766-8778. [PMID: 32886606 PMCID: PMC9721526 DOI: 10.1109/tpami.2020.3013679] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
We introduce a method for training neural networks to perform image or volume segmentation in which prior knowledge about the topology of the segmented object can be explicitly provided and then incorporated into the training process. By using the differentiable properties of persistent homology, a concept used in topological data analysis, we can specify the desired topology of segmented objects in terms of their Betti numbers and then drive the proposed segmentations to contain the specified topological features. Importantly this process does not require any ground-truth labels, just prior knowledge of the topology of the structure being segmented. We demonstrate our approach in four experiments: one on MNIST image denoising and digit recognition, one on left ventricular myocardium segmentation from magnetic resonance imaging data from the UK Biobank, one on the ACDC public challenge dataset and one on placenta segmentation from 3-D ultrasound. We find that embedding explicit prior knowledge in neural network segmentation tasks is most beneficial when the segmentation task is especially challenging and that it can be used in either a semi-supervised or post-processing context to extract a useful training gradient from images without pixelwise labels.
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Jiang W, Jiang W, Jin P, Zhang J, Xia J, Wei W, Qing B. Application of 3D printing technology combined with PBL teaching method in clinical teaching of cerebrovascular disease: An observational study. Medicine (Baltimore) 2022; 101:e31970. [PMID: 36451448 PMCID: PMC9704919 DOI: 10.1097/md.0000000000031970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Traditional clinical teaching does not allow medical students to combine theoretical knowledge with practical knowledge. As such, we aimed to determine the effectiveness of three dimensional (3D) printing technology combined with problem-based learning (PBL) in the clinical teaching of cerebrovascular diseases. Medical interns were randomly divided into an experimental group (n = 136) that was taught using 3D printing technology + PBL method and a control group (n = 133) that was taught using traditional methods. We compared assessment results of theoretical and clinical practice skills and the subjective evaluation of teaching methods between the 2 groups. The assessment results of the experimental group were significantly higher than those in the control group (P < .05). The survey assessing the evaluation of teaching methods showed higher satisfaction with teaching methods, increased learning interest, and improvement in the spatial thinking ability of interns in the experimental group compared to the control group (P < .05). There was no significant difference when assessing which teaching method better improved the interns' understanding of cerebrovascular diseases (P < .05). The application of 3D printing technology combined with the PBL teaching method in neurosurgery clinical teaching can stimulate interest in learning and significantly improve academic performance and problem-analysis and solving skills.
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Affiliation(s)
- Wenqing Jiang
- Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
- Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Wei Jiang
- Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
- Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Peng Jin
- Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
- Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Jing Zhang
- Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
- Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Junjie Xia
- Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
- Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Wenfeng Wei
- Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
- Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Bao Qing
- Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
- Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
- * Correspondence: Qing Bao, Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu 213017, China (e-mail: )
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Mill J, Montoliu H, Moustafa AH, Olivares AL, Albors C, Aguado AM, Medina E, Ceresa M, Freixa X, Arzamendi D, Cochet H, Camara O. Domain expert evaluation of advanced visual computing solutions and 3D printing for the planning of the left atrial appendage occluder interventions. Int J Bioprint 2022; 9:640. [PMID: 36636130 PMCID: PMC9830994 DOI: 10.18063/ijb.v9i1.640] [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: 05/04/2022] [Accepted: 07/30/2022] [Indexed: 11/16/2022] Open
Abstract
Advanced visual computing solutions and three-dimensional (3D) printing are moving from engineering to clinical pipelines for training, planning, and guidance of complex interventions. 3D imaging and rendering, virtual reality (VR), and in-silico simulations, as well as 3D printing technologies provide complementary information to better understand the structure and function of the organs, thereby improving and personalizing clinical decisions. In this study, we evaluated several advanced visual computing solutions, such as web-based 3D imaging visualization, VR, and computational fluid simulations, together with 3D printing, for the planning of the left atrial appendage occluder (LAAO) device implantations. Six cardiologists tested different technologies in pre-operative data of five patients to identify the usability, limitations, and requirements for the clinical translation of each technology through a qualitative questionnaire. The obtained results demonstrate the potential impact of advanced visual computing solutions and 3D printing to improve the planning of LAAO interventions as well as the need for their integration into a single workflow to be used in a clinical environment.
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Affiliation(s)
- Jordi Mill
- Physense, BCN Medtech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, 08018 Spain
| | - Helena Montoliu
- Physense, BCN Medtech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, 08018 Spain
| | - Abdel H. Moustafa
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, 08025, Spain
| | - Andy L. Olivares
- Physense, BCN Medtech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, 08018 Spain
| | - Carlos Albors
- Physense, BCN Medtech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, 08018 Spain
| | - Ainhoa M. Aguado
- Physense, BCN Medtech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, 08018 Spain
| | - Elodie Medina
- Physense, BCN Medtech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, 08018 Spain
| | - Mario Ceresa
- Physense, BCN Medtech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, 08018 Spain
| | - Xavier Freixa
- Department of Cardiology, Hospital Clinic de Barcelona, 08036, Spain
| | - Dabit Arzamendi
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, 08025, Spain
| | - Hubert Cochet
- IHU Liryc, CHU Bordeaux, Université Bordeaux, Inserm 1045, Pessac, France
| | - Oscar Camara
- Physense, BCN Medtech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, 08018 Spain,Corresponding author: Oscar Camara ()
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Jafari A, Ajji Z, Mousavi A, Naghieh S, Bencherif SA, Savoji H. Latest Advances in 3D Bioprinting of Cardiac Tissues. ADVANCED MATERIALS TECHNOLOGIES 2022; 7:2101636. [PMID: 38044954 PMCID: PMC10691862 DOI: 10.1002/admt.202101636] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Indexed: 12/05/2023]
Abstract
Cardiovascular diseases (CVDs) are known as the major cause of death worldwide. In spite of tremendous advancements in medical therapy, the gold standard for CVD treatment is still transplantation. Tissue engineering, on the other hand, has emerged as a pioneering field of study with promising results in tissue regeneration using cells, biological cues, and scaffolds. Three-dimensional (3D) bioprinting is a rapidly growing technique in tissue engineering because of its ability to create complex scaffold structures, encapsulate cells, and perform these tasks with precision. More recently, 3D bioprinting has made its debut in cardiac tissue engineering, and scientists are investigating this technique for development of new strategies for cardiac tissue regeneration. In this review, the fundamentals of cardiac tissue biology, available 3D bioprinting techniques and bioinks, and cells implemented for cardiac regeneration are briefly summarized and presented. Afterwards, the pioneering and state-of-the-art works that have utilized 3D bioprinting for cardiac tissue engineering are thoroughly reviewed. Finally, regulatory pathways and their contemporary limitations and challenges for clinical translation are discussed.
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Affiliation(s)
- Arman Jafari
- Institute of Biomedical Engineering, Department of Pharmacology and Physiology, Faculty of Medicine, University of Montreal, Montreal, QC, H3T 1J4, Canada
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, H3T 1C5, Canada
- Montreal TransMedTech Institute, Montreal, QC, H3T 1J4, Canada
| | - Zineb Ajji
- Institute of Biomedical Engineering, Department of Pharmacology and Physiology, Faculty of Medicine, University of Montreal, Montreal, QC, H3T 1J4, Canada
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, H3T 1C5, Canada
- Montreal TransMedTech Institute, Montreal, QC, H3T 1J4, Canada
| | - Ali Mousavi
- Institute of Biomedical Engineering, Department of Pharmacology and Physiology, Faculty of Medicine, University of Montreal, Montreal, QC, H3T 1J4, Canada
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, H3T 1C5, Canada
- Montreal TransMedTech Institute, Montreal, QC, H3T 1J4, Canada
| | - Saman Naghieh
- Division of Biomedical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, S7N 5A9, Canada
| | - Sidi A. Bencherif
- Department of Chemical Engineering, Northeastern University, Boston, MA 02115, United States
- Department of Bioengineering, Northeastern University, Boston, MA 02115, United States
- Sorbonne University, UTC CNRS UMR 7338, Biomechanics and Bioengineering (BMBI), University of Technology of Compiègne, 60203 Compiègne, France
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02128, United States
| | - Houman Savoji
- Institute of Biomedical Engineering, Department of Pharmacology and Physiology, Faculty of Medicine, University of Montreal, Montreal, QC, H3T 1J4, Canada
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, H3T 1C5, Canada
- Montreal TransMedTech Institute, Montreal, QC, H3T 1J4, Canada
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Zukunft der interventionellen Kardiologie. Herz 2022; 47:518-523. [DOI: 10.1007/s00059-022-05146-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 11/04/2022]
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You Y, Niu Y, Sun F, Huang S, Ding P, Wang X, Zhang X, Zhang J. Three-dimensional printing and 3D slicer powerful tools in understanding and treating neurosurgical diseases. Front Surg 2022; 9:1030081. [PMCID: PMC9614074 DOI: 10.3389/fsurg.2022.1030081] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 09/28/2022] [Indexed: 11/13/2022] Open
Abstract
With the development of the 3D printing industry, clinicians can research 3D printing in preoperative planning, individualized implantable materials manufacturing, and biomedical tissue modeling. Although the increased applications of 3D printing in many surgical disciplines, numerous doctors do not have the specialized range of abilities to utilize this exciting and valuable innovation. Additionally, as the applications of 3D printing technology have increased within the medical field, so have the number of printable materials and 3D printers. Therefore, clinicians need to stay up-to-date on this emerging technology for benefit. However, 3D printing technology relies heavily on 3D design. 3D Slicer can transform medical images into digital models to prepare for 3D printing. Due to most doctors lacking the technical skills to use 3D design and modeling software, we introduced the 3D Slicer to solve this problem. Our goal is to review the history of 3D printing and medical applications in this review. In addition, we summarized 3D Slicer technologies in neurosurgery. We hope this article will enable many clinicians to leverage the power of 3D printing and 3D Slicer.
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Affiliation(s)
- Yijie You
- Department of Neurosurgery, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Yunlian Niu
- Department of Neurology, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Fengbing Sun
- Department of Neurosurgery, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Sheng Huang
- Department of Neurosurgery, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Peiyuan Ding
- Department of Neurosurgery, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Xuhui Wang
- Department of Neurosurgery, Xinhua Hospital Chongming Branch, Shanghai, China,Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine, The Cranial Nerve Disease Center of Shanghai JiaoTong University, Shanghai, China
| | - Xin Zhang
- Educational Administrative Department, Shanghai Chongming Health School, Shanghai, China,Correspondence: Xin Zhang Jian Zhang
| | - Jian Zhang
- Department of Neurosurgery, Xinhua Hospital Chongming Branch, Shanghai, China,Correspondence: Xin Zhang Jian Zhang
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Castellanos JM, Barbery D, Yefimov A, Dang PN. Preoperative planning using virtual reality for percutaneous transseptal valve-in-valve transcatheter mitral valve replacement: a case report. Eur Heart J Case Rep 2022; 6:ytac384. [PMID: 36285227 PMCID: PMC9585901 DOI: 10.1093/ehjcr/ytac384] [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: 03/23/2022] [Revised: 04/26/2022] [Accepted: 09/13/2022] [Indexed: 11/06/2022]
Abstract
Background Virtual reality (VR) technology has been implemented as a pre-procedural planning tool for cardiovascular interventions to enable detailed evaluation of patient anatomy from different vantage points. Here, we employed a VR platform to preoperatively plan for percutaneous valve-in-valve transcatheter mitral replacement (ViV-TMVR) in a prohibitive surgical candidate. Case summary An 85-year-old male with a history of two prior sternotomies for bioprosthetic aortic valve (AV) and mitral valve (MV) 31 mm Medtronic Mosaic bioprosthesis presented with severe mitral regurgitation from a degenerative bioprosthetic MV. The patient was deemed a prohibitive surgical candidate for a third sternotomy and instead was recommended a percutaneous transseptal ViV-TMVR. An electrocardiogram-gated chest computed tomography (CT) provided a neo-left-ventricular outflow tract (neo-LVOT) of 1.89 cm2. This CT was reconstructed to create a 360° VR (360VR) model. A 29 mm SAPIEN three bioprosthetic valve, selected based on the already implanted MV, was placed inside the bioprosthetic MV and analysed in VR at different angles to ensure it would not obstruct the LVOT. The neo-LVOT measured in VR was 3.02 cm2, which would allow for sufficient blood flow without significant obstruction from the new SAPIEN three bioprosthetic valve. The patient tolerated the procedure well. Discussion This case demonstrates the utility of VR as a pre-procedural planning tool for interventional cardiology procedures. Preoperative planning in VR alleviated concerns regarding obstruction of the neo-LVOT and helped confirm safe implantation by clearly showing the three-dimensional spatial relationship between the implants and surrounding patient anatomy.
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Affiliation(s)
| | | | - Alex Yefimov
- Surgical Theater, Clinical Department, Cleveland, OH, USA
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Tsolakis IA, Papaioannou W, Papadopoulou E, Dalampira M, Tsolakis AI. Comparison in Terms of Accuracy between DLP and LCD Printing Technology for Dental Model Printing. Dent J (Basel) 2022; 10:dj10100181. [PMID: 36285991 PMCID: PMC9600557 DOI: 10.3390/dj10100181] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/21/2022] Open
Abstract
Background: The aim of this study is to evaluate the accuracy of a Liquid Crystal Display (LCD) 3D printer compared to a Direct Light Processing (DLP) 3D printer for dental model printing. Methods: Two different printers in terms of 3D printing technology were used in this study. One was a DLP 3D printer and one an LCD 3D printer. The accuracy of the printers was evaluated in terms of trueness and precision. Ten STL reference files were used for this study. For trueness, each STL file was printed once with each 3D printer. For precision, one randomly chosen STL file was printed 10 times with each 3D printer. Afterward, the models were scanned with a model scanner, and reverse engineering software was used for the STL comparisons. Results: In terms of trueness, the comparison between the LCD 3D printer and DLP 3D printer was statistically significant, with a p-value = 0.004. For precision, the comparison between the LCD 3D printer and the DLP 3D printer was statistically significant, with a p-value = 0.011. Conclusions: The DLP 3D printer is more accurate in terms of dental model printing than the LCD 3D printer. However, both DLP and LCD printers can accurately be used to print dental models for the fabrication of orthodontic appliances.
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Affiliation(s)
- Ioannis A. Tsolakis
- Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Correspondence:
| | - William Papaioannou
- Department of Preventive & Community Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 157 72 Athens, Greece
| | - Erofili Papadopoulou
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodis-Trian University of Athens, 106 79 Athens, Greece
| | | | - Apostolos I. Tsolakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 157 72 Athens, Greece
- Department of Orthodontics, Case Western Reserve University, Cleveland, OH 44106, USA
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Ma Y, Mao Y, Zhu G, Yang J. Application of cardiovascular 3-dimensional printing in Transcatheter aortic valve replacement. CELL REGENERATION 2022; 11:35. [PMID: 36121512 PMCID: PMC9485371 DOI: 10.1186/s13619-022-00129-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 07/05/2022] [Indexed: 11/10/2022]
Abstract
AbstractTranscatheter aortic valve replacement (TAVR) has been performed for nearly 20 years, with reliable safety and efficacy in moderate- to high-risk patients with aortic stenosis or regurgitation, with the advantage of less trauma and better prognosis than traditional open surgery. However, because surgeons have not been able to obtain a full view of the aortic root, 3-dimensional printing has been used to reconstruct the aortic root so that they could clearly and intuitively understand the specific anatomical structure. In addition, the 3D printed model has been used for the in vitro simulation of the planned procedures to predict the potential complications of TAVR, the goal being to provide guidance to reasonably plan the procedure to achieve the best outcome. Postprocedural 3D printing can be used to understand the depth, shape, and distribution of the stent. Cardiovascular 3D printing has achieved remarkable results in TAVR and has a great potential.
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Suganna M, Kausher H, Rownaq Ali ABM, Abed MM, Albishi WS, Al Hajji FA, Sultan NA. Knowledge on Applications of 3D Design and Printing in Dentistry Among Dental Practitioners in Saudi Arabia: A Questionnaire-Based Survey. Cureus 2022; 14:e28379. [PMID: 36171830 PMCID: PMC9508789 DOI: 10.7759/cureus.28379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 08/24/2022] [Indexed: 11/05/2022] Open
Abstract
Background: This knowledge, attitude, and practices (KAP) survey will provide baseline data and identify gaps that may facilitate understanding and further action to plan, implement, and evaluate practice toward 3D-printing technology among dental practitioners in Saudi Arabia. Aims and objectives: The present study aims to assess dental practitioners' self-reported knowledge, attitude, and practice of 3D printing in Saudi Arabia. Methodology: A cross-sectional, closed-ended questionnaire of registered dental practitioners in Saudi Arabia was conducted. A sample size of 156 was considered for analysis. After obtaining approval from the Institutional Review Board, Riyadh Elm University, the research was conducted during the month of April 2022 amongst 154 registered dental practitioners. The research was distributed among dental health specialists either working in dental colleges, dental clinics, or both in government as well as private settings. Dentists who were not actively involved in 3D printing were excluded. SPSS software, version 25.0, (IBM Corp., Armonk, NY) was used to analyze the data. Results and conclusion: Of all dentists included in the study, 98% were found to be aware that 3D printing in dentistry is used in Saudi Arabia and 2 % were not aware of its usage in Saudi Arabia. In total, 78.60% of the dentists felt that 3D-printed implant guides made the placement of implants the most accurate and least complicated procedure, and 21.40% of the dentists felt it was the least accurate and most complicated procedure.
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Successful Management in an Infant Patient of PHACE Syndrome with a Complicated Aortic Arch Anomaly. Case Rep Pediatr 2022; 2022:5947951. [PMID: 36059580 PMCID: PMC9433226 DOI: 10.1155/2022/5947951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/05/2022] [Accepted: 08/09/2022] [Indexed: 11/17/2022] Open
Abstract
PHACE syndrome is a congenital disorder often associated with a cervicofacial infantile hemangioma and complicated cardiovascular malformations. Patients with PHACE syndrome often have complex aortic arch anomalies, longer aortic stenosis or agenesis segments, and increased vascular tortuosity; therefore, perioperative management and surgical repair are challenging. We report a case of a female infant with PHACE syndrome and complex cardiovascular anomalies such as a double aortic arch associated with interruption of the left aortic arch, coarctation of the right aortic arch, patent ductus arteriosus, ventricular septal defect, and atrial septal defect. She was born at 36 weeks of gestation (birth weight, 2,150 g) and the diagnosis was confirmed by three-dimensional computed tomography. Because her patent ductus arteriosus did not close at first, her heart failure was managed preoperatively without prostaglandin E1. We initially attempted to promote weight gain. Surgical planning and simulation were performed using the patient-specific three-dimensional cardiovascular model created from computed tomography data. She underwent a successful aortic arch reconstruction by an end-to-side anastomosis with anterior patch augmentation at the age of 56 days. Detailed planning and simulation before surgery were vital in achieving favorable outcomes. Careful management and surgical planning using a patient-specific three-dimensional model are vital, especially in patients with complex malformations, such as in our case.
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Jain P, Kathuria H, Dubey N. Advances in 3D bioprinting of tissues/organs for regenerative medicine and in-vitro models. Biomaterials 2022; 287:121639. [PMID: 35779481 DOI: 10.1016/j.biomaterials.2022.121639] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/05/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022]
Abstract
Tissue/organ shortage is a major medical challenge due to donor scarcity and patient immune rejections. Furthermore, it is difficult to predict or mimic the human disease condition in animal models during preclinical studies because disease phenotype differs between humans and animals. Three-dimensional bioprinting (3DBP) is evolving into an unparalleled multidisciplinary technology for engineering three-dimensional (3D) biological tissue with complex architecture and composition. The technology has emerged as a key driver by precise deposition and assembly of biomaterials with patient's/donor cells. This advancement has aided in the successful fabrication of in vitro models, preclinical implants, and tissue/organs-like structures. Here, we critically reviewed the current state of 3D-bioprinting strategies for regenerative therapy in eight organ systems, including nervous, cardiovascular, skeletal, integumentary, endocrine and exocrine, gastrointestinal, respiratory, and urinary systems. We also focus on the application of 3D bioprinting to fabricated in vitro models to study cancer, infection, drug testing, and safety assessment. The concept of in situ 3D bioprinting is discussed, which is the direct printing of tissues at the injury or defect site for reparative and regenerative therapy. Finally, issues such as scalability, immune response, and regulatory approval are discussed, as well as recently developed tools and technologies such as four-dimensional and convergence bioprinting. In addition, information about clinical trials using 3D printing has been included.
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Affiliation(s)
- Pooja Jain
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, Maharashtra, India; Faculty of Dentistry, National University of Singapore, Singapore
| | - Himanshu Kathuria
- Department of Pharmacy, National University of Singapore, 117543, Singapore; Nusmetic Pte Ltd, Makerspace, I4 Building, 3 Research Link Singapore, 117602, Singapore.
| | - Nileshkumar Dubey
- Faculty of Dentistry, National University of Singapore, Singapore; ORCHIDS: Oral Care Health Innovations and Designs Singapore, National University of Singapore, Singapore.
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Three-Dimensional Printing Technology in Orthodontics for Dental Models: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9081106. [PMID: 35892609 PMCID: PMC9330810 DOI: 10.3390/children9081106] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 12/28/2022]
Abstract
Background: Three-dimensional printing technology is an additive manufacturing technology that is used to reconstruct 3D objects. In the last decade, it has been rapidly involved in dentistry and in orthodontics. This article aims to review the literature and present the accuracy of different 3D printer types and any factors that could affect the 3D printing of dental models in the orthodontic field. Methods: The search strategy of this systematic review included keywords in combination with MeSH terms in Medline, Scopus, and Cochrane Library until June 2022 and only in English. Results: Eleven articles were selected for our study. All the articles were in vitro prospective studies, and they presented a low risk of bias. The results suggested that the accuracy of a printed dental cast can be affected by the different types of 3D technologies, the dental cast’s base design, and the printing materials. The accuracy appears to not be affected by the layer height and the position of the model on the building template. Conclusions: According to this systematic review, all different types of 3D technology can produce clinically accepted results for orthodontic purposes. There is a need for more studies to clarify the accuracy and added value of 3D printing technology in orthodontics.
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Valverde I, Gomez G, Byrne N, Anwar S, Silva Cerpa MA, Martin Talavera M, Pushparajah K, Velasco Forte MN. Criss-cross heart three-dimensional printed models in medical education: A multicenter study on their value as a supporting tool to conventional imaging. ANATOMICAL SCIENCES EDUCATION 2022; 15:719-730. [PMID: 34008341 DOI: 10.1002/ase.2105] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/30/2021] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
The utility of three-dimensional (3D) printed models for medical education in complex congenital heart disease (CHD) is sparse and limited. The purpose of this study was to evaluate the utility of 3D printed models for medical education in criss-cross hearts covering a wide range of participants with different levels of knowledge and experience, from medical students, clinical fellows up to senior medical personnel. Study participants were enrolled from four dedicated imaging workshops developed between 2016 and 2019. The study design was a non-randomized cross-over study to evaluate 127 participants' level of understanding of the criss-cross heart anatomy. This was evaluated using the scores obtained following teaching with conventional images (echocardiography and magnetic resonance imaging) versus a 3D printed model learning approach. A significant improvement in anatomical knowledge of criss-cross heart anatomy was observed when comparing conventional imaging test scores to 3D printed model tests [76.9% (61.5%-87.8%) vs. 84.6% (76.9%-96.2%), P < 0.001]. The increase in the questionnaire marks was statistically significant across all academic groups (consultants in pediatric cardiology, fellows in pediatric cardiology, and medical students). Ninety-four percent (120) and 95.2% (121) of the participants agreed or strongly agreed, respectively, that 3D models helped them to better understand the medical images. Participants scored their overall satisfaction with the 3D printed models as 9.1 out of 10 points. In complex CHD such as criss-cross hearts, 3D printed replicas improve the understanding of cardiovascular anatomy. They enhanced the teaching experience especially when approaching medical students.
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Affiliation(s)
- Israel Valverde
- Pediatric Cardiology Unit, Hospital Virgen del Rocio, Seville, Spain
- Cardiovascular Pathology Unit and Fabrication Laboratory, Institute of Biomedicine of Seville, Seville, Spain
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department of Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St Thomas' National Health Service Foundation Trust, London, UK
| | - Gorka Gomez
- Cardiovascular Pathology Unit and Fabrication Laboratory, Institute of Biomedicine of Seville, Seville, Spain
| | - Nick Byrne
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Shafkat Anwar
- Division of Cardiology, Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, California, USA
| | | | | | - Kuberan Pushparajah
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department of Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St Thomas' National Health Service Foundation Trust, London, UK
| | - Maria Nieves Velasco Forte
- Cardiovascular Pathology Unit and Fabrication Laboratory, Institute of Biomedicine of Seville, Seville, Spain
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department of Pediatric Cardiology, University of Bristol, Bristol Royal Hospital for Children, Bristol, UK
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Kolli KK, Jang SJ, Zahid A, Caprio A, Alaie S, Moghadam AAA, Xu P, Shepherd R, Mosadegh B, Dunham S. Improved Functional Assessment of Ischemic Severity Using 3D Printed Models. Front Cardiovasc Med 2022; 9:909680. [PMID: 35845036 PMCID: PMC9279862 DOI: 10.3389/fcvm.2022.909680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/25/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To develop a novel in vitro method for evaluating coronary artery ischemia using a combination of non-invasive coronary CT angiograms (CCTA) and 3D printing (FFR3D). Methods Twenty eight patients with varying degrees of coronary artery disease who underwent non-invasive CCTA scans and invasive fractional flow reserve (FFR) of their epicardial coronary arteries were included in this study. Coronary arteries were segmented and reconstructed from CCTA scans using Mimics (Materialize). The segmented models were then 3D printed using a Carbon M1 3D printer with urethane methacrylate (UMA) family of rigid resins. Physiological coronary circulation was modeled in vitro as flow-dependent stenosis resistance in series with variable downstream resistance. A range of physiological flow rates (Q) were applied using a peristaltic steady flow pump and titrated with a flow sensor. The pressure drop (ΔP) and the pressure ratio (Pd/Pa) were assessed for patient-specific aortic pressure (Pa) and differing flow rates (Q) to evaluate FFR3D using the 3D printed model. Results There was a good positive correlation (r = 0.87, p < 0.0001) between FFR3D and invasive FFR. Bland-Altman analysis revealed a good concordance between the FFR3D and invasive FFR values with a mean bias of 0.02 (limits of agreement: −0.14 to 0.18; p = 0.2). Conclusions 3D printed patient-specific models can be used in a non-invasive in vitro environment to quantify coronary artery ischemia with good correlation and concordance to that of invasive FFR.
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Affiliation(s)
- Kranthi K. Kolli
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College, New York, NY, United States
- *Correspondence: Kranthi K. Kolli
| | - Sun-Joo Jang
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College, New York, NY, United States
| | - Abdul Zahid
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College, New York, NY, United States
| | - Alexandre Caprio
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College, New York, NY, United States
| | - Seyedhamidreza Alaie
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College, New York, NY, United States
| | - Amir Ali Amiri Moghadam
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College, New York, NY, United States
| | - Patricia Xu
- Department of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, United States
| | - Robert Shepherd
- Department of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, United States
| | - Bobak Mosadegh
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College, New York, NY, United States
| | - Simon Dunham
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College, New York, NY, United States
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