Living the heart in three dimensions: applications of 3D printing in CHD

2019 ◽  
Vol 29 (06) ◽  
pp. 733-743 ◽  
Author(s):  
Mari Nieves Velasco Forte ◽  
Tarique Hussain ◽  
Arno Roest ◽  
Gorka Gomez ◽  
Monique Jongbloed ◽  
...  
Keyword(s):  
3D Printing ◽  
Heart Surgery ◽  
Wide Spectrum ◽  
Three Dimensional ◽  
Structural Heart Disease ◽  
Medical Personnel ◽  
Three Dimensions ◽  
Patient Specific ◽  
3D Printed

AbstractAdvances in biomedical engineering have led to three-dimensional (3D)-printed models being used for a broad range of different applications. Teaching medical personnel, communicating with patients and relatives, planning complex heart surgery, or designing new techniques for repair of CHD via cardiac catheterisation are now options available using patient-specific 3D-printed models. The management of CHD can be challenging owing to the wide spectrum of morphological conditions and the differences between patients. Direct visualisation and manipulation of the patients’ individual anatomy has opened new horizons in personalised treatment, providing the possibility of performing the whole procedure in vitro beforehand, thus anticipating complications and possible outcomes. In this review, we discuss the workflow to implement 3D printing in clinical practice, the imaging modalities used for anatomical segmentation, the applications of this emerging technique in patients with structural heart disease, and its limitations and future directions.

scholarly journals Three-dimensionally printed polycaprolactone/multicomponent bioactive glass scaffolds for potential application in bone tissue engineering

2020 ◽  
Vol 6 (1) ◽  
pp. 57-69
Author(s):  
Amirhosein Fathi ◽  
Farzad Kermani ◽  
Aliasghar Behnamghader ◽  
Sara Banijamali ◽  
Masoud Mozafari ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
3D Printing ◽  
Bone Tissue Engineering ◽  
Bone Tissue ◽  
Three Dimensional ◽  
Layer By Layer ◽  
Composite Scaffolds ◽  
3D Printed ◽  
Co Doped

AbstractOver the last years, three-dimensional (3D) printing has been successfully applied to produce suitable substitutes for treating bone defects. In this work, 3D printed composite scaffolds of polycaprolactone (PCL) and strontium (Sr)- and cobalt (Co)-doped multi-component melt-derived bioactive glasses (BGs) were prepared for bone tissue engineering strategies. For this purpose, 30% of as-prepared BG particles (size <38 μm) were incorporated into PCL, and then the obtained composite mix was introduced into a 3D printing machine to fabricate layer-by-layer porous structures with the size of 12 × 12 × 2 mm3.The scaffolds were fully characterized through a series of physico-chemical and biological assays. Adding the BGs to PCL led to an improvement in the compressive strength of the fabricated scaffolds and increased their hydrophilicity. Furthermore, the PCL/BG scaffolds showed apatite-forming ability (i.e., bioactivity behavior) after being immersed in simulated body fluid (SBF). The in vitro cellular examinations revealed the cytocompatibility of the scaffolds and confirmed them as suitable substrates for the adhesion and proliferation of MG-63 osteosarcoma cells. In conclusion, 3D printed composite scaffolds made of PCL and Sr- and Co-doped BGs might be potentially-beneficial bone replacements, and the achieved results motivate further research on these materials.

Investigation of three-dimensional printing materials for printing aorta model replicating Type B aortic dissection

2021 ◽  
Vol 17 ◽  
Author(s):  
Chia-An Wu ◽  
Andrew Squelch ◽  
Zhonghua Sun
Keyword(s):  
3D Printing ◽  
Aortic Dissection ◽  
Three Dimensional ◽  
Ct Images ◽  
Patient Specific ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Ct Attenuation ◽  
Significant Difference ◽  
3D Printed

Aim: To determine a printing material that has both elastic property and radiology equivalence close to real aorta for simulation of endovascular stent graft repair of aortic dissection. Background: With the rapid development of three-dimensional (3D) printing technology, a patient-specific 3D printed model is able to help surgeons to make better treatment plan for Type B aortic dissection patients. However, the radiological properties of most 3D printing materials have not been well characterized. This study aims to investigate the appropriate materials for printing human aorta with mechanical and radiological properties similar to the real aortic computed tomography (CT) attenuation. Objective: Quantitative assessment of CT attenuation of different materials used in 3D printed models of aortic dissection for developing patient-specific 3D printed aorta models to simulate type B aortic dissection. Method: A 25-mm length of aorta model was segmented from a patient’s image dataset with diagnosis of type B aortic dissection. Four different elastic commercial 3D printing materials, namely Agilus A40 and A50, Visijet CE-NT A30 and A70 were selected and printed with different hardness. Totally four models were printed out and conducted CT scanned twice on a 192-slice CT scanner using the standard aortic CT angiography protocol, with and without contrast inside the lumen.Five reference points with region of interest (ROI) of 1.77 mm2 were selected at the aortic wall and intimal flap and their Hounsfield units (HU) were measured and compared with the CT attenuation of original CT images. The comparison between the patient’s aorta and models was performed through a paired-sample t-test to determine if there is any significant difference. Result: The mean CT attenuation of aortic wall of the original CT images was 80.7 HU. Analysis of images without using contrast medium showed that the material of Agilus A50 produced the mean CT attenuation of 82.6 HU, which is similar to that of original CT images. The CT attenuation measured at images acquired with other three materials was significantly lower than that of original images (p<0.05). After adding contrast medium, Visijet CE-NT A30 had an average CT attenuation of 90.6 HU, which is close to that of the original images with statistically significant difference (p>0.05). In contrast, the CT attenuation measured at images acquired with other three materials (Agilus A40, A50 and Visiject CE-NT A70) was 129 HU, 135 HU and 129.6 HU, respectively, which is significantly higher than that of original CT images (p<0.05). Conclusion: Both Visijet CE-NT and Agilus have tensile strength and elongation close to real patient’s tissue properties producing similar CT attenuation. Visijet CE-NT A30 is considered the appropriate material for printing aorta to simulate contrast-enhanced CT imaging of type B aortic dissection. Due to lack of body phantom in the experiments, further research with simulation of realistic anatomical body environment should be conducted.

scholarly journals Evaluation of the 3D Printing Accuracy of a Dental Model According to Its Internal Structure and Cross-Arch Plate Design: An In Vitro Study

Materials ◽  
2020 ◽  
Vol 13 (23) ◽  
pp. 5433
Author(s):  
Seung-Ho Shin ◽  
Jung-Hwa Lim ◽  
You-Jung Kang ◽  
Jee-Hwan Kim ◽  
June-Sung Shim ◽  
...  
Keyword(s):  
3D Printing ◽  
Internal Structure ◽  
Three Dimensional ◽  
In Vitro Study ◽  
Thick Shell ◽  
Plate Design ◽  
Dental Model ◽  
3D Printed ◽  
Modeling Data

The amount of photopolymer material consumed during the three-dimensional (3D) printing of a dental model varies with the volume and internal structure of the modeling data. This study analyzed how the internal structure and the presence of a cross-arch plate influence the accuracy of a 3D printed dental model. The model was designed with a U-shaped arch and the palate removed (Group U) or a cross-arch plate attached to the palate area (Group P), and the internal structure was divided into five types. The trueness and precision were analyzed for accuracy comparisons of the 3D printed models. Two-way ANOVA of the trueness revealed that the accuracy was 135.2 ± 26.3 µm (mean ± SD) in Group U and 85.6 ± 13.1 µm in Group P. Regarding the internal structure, the accuracy was 143.1 ± 46.8 µm in the 1.5 mm-thick shell group, which improved to 111.1 ± 31.9 µm and 106.7 ± 26.3 µm in the roughly filled and fully filled models, respectively. The precision was 70.3 ± 19.1 µm in Group U and 65.0 ± 8.8 µm in Group P. The results of this study suggest that a cross-arch plate is necessary for the accurate production of a model using 3D printing regardless of its internal structure. In Group U, the error during the printing process was higher for the hollowed models.

scholarly journals Three-dimensional Printing Versus Conventional Machining in the Creation of a Meatal Urethral Dilator: a Cost and Mechanical Strength Analysis

2020 ◽  
Author(s):  
Michael Yue-Cheng Chen ◽  
Jacob Skewes ◽  
Ryan Daley ◽  
Maria Ann Woodruff ◽  
Nicholas John Rukin
Keyword(s):  
3D Printing ◽  
Three Dimensional ◽  
Patient Specific ◽  
Strength Analysis ◽  
Fused Deposition Modelling ◽  
3D Printer ◽  
Current Time ◽  
Fused Deposition ◽  
3D Printed ◽  
Conventional Machining

Abstract BackgroundThree-dimensional (3D) printing is a promising technology but the limitations are often poorly understood. We compare different 3D printingmethods with conventional machining techniques in manufacturing meatal urethral dilators which were recently removed from the Australian market. MethodsA prototype dilator was 3D printed vertically orientated on a low cost fused deposition modelling (FDM) 3D printer in polylactic acid (PLA) and acrylonitrile butadiene styrene (ABS). It was also 3D printed horizontally orientated in ABS on a high-end FDM 3D printer with soluble support material, as well as on a SLS 3D printer in medical nylon. The dilator was also machined in stainless steel using a lathe. All dilators were tested mechanically in a custom rig by hanging calibrated weights from the handle until the dilator snapped. ResultsThe horizontally printed ABS dilator experienced failure at a greater load than the vertically printed PLA and ABS dilators respectively (503g vs 283g vs 163g, p < 0.001). The SLS nylon dilator and machined steel dilator did not fail. The steel dilator is most expensive with a quantity of five at 98 USD each, but this decreases to 30 USD each for a quantity of 1000. In contrast, the cost for the SLS dilator is 33 USD each for five and 27 USD each for 1000. ConclusionsAt the current time 3D printing is not a replacement for conventional manufacturing. 3D printing is best used for patient-specific parts, prototyping or manufacturing complex parts that have additional functionality that cannot otherwise beachieved.

Investigations for Wax Coated 3D Printed Hybrid Patterns for Partial Dentures

2019 ◽  
Author(s):  
Kamaljit Singh Boparai ◽  
Gurpartap Singh ◽  
Rupinder Singh ◽  
Sarabjit Singh
Keyword(s):  
Fused Deposition Modeling ◽  
Three Dimensional ◽  
Surface Hardness ◽  
Dimensional Accuracy ◽  
Acrylonitrile Butadiene Styrene ◽  
Processing Technique ◽  
Patient Specific ◽  
Fused Deposition ◽  
3D Printed

Abstract In this work, 3D printed master patterns of acrylonitrile butadiene styrene (ABS) thermoplastic material have been used for the preparation of Ni-Cr based functional prototypes as partial dentures (PD). The study started with patient specific three dimensional (3D), CAD data (fetched through scanning). This data was used for preparation of .STL file for printing of master patterns on fused deposition modeling (FDM) setup. The 3D printed master patterns were further wax coated to reduce the surface irregularities (as cost effective post processing technique). The hybrid patterns were subjected to investment casting for the preparation of Ni-Cr based PD. The finally prepared functional prototypes as PD were optimized for dimensional accuracy, surface finish and surface hardness as responses. The results are visualized and supported by photomicrographs and in-vitro analysis.

scholarly journals Multi-layer Scaffolds of Poly(caprolactone), Poly(glycerol sebacate) and Bioactive Glasses Manufactured by Combined 3D Printing and Electrospinning

Nanomaterials ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 626 ◽  
Author(s):  
Adja B. R. Touré ◽  
Elisa Mele ◽  
Jamieson K. Christie
Keyword(s):  
3D Printing ◽  
Three Dimensional ◽  
Bioactive Glasses ◽  
Multi Scale ◽  
Potential Applications ◽  
3D Printed ◽  
Excellent Adhesion ◽  
Poly Caprolactone ◽  
Hydrolysis Of

Three-dimensional (3D) printing has been combined with electrospinning to manufacture multi-layered polymer/glass scaffolds that possess multi-scale porosity, are mechanically robust, release bioactive compounds, degrade at a controlled rate and are biocompatible. Fibrous mats of poly (caprolactone) (PCL) and poly (glycerol sebacate) (PGS) have been directly electrospun on one side of 3D-printed grids of PCL-PGS blends containing bioactive glasses (BGs). The excellent adhesion between layers has resulted in composite scaffolds with a Young’s modulus of 240–310 MPa, higher than that of 3D-printed grids (125–280 MPa, without the electrospun layer). The scaffolds degraded in vitro by releasing PGS and BGs, reaching a weight loss of ~14% after 56 days of incubation. Although the hydrolysis of PGS resulted in the acidification of the buffer medium (to a pH of 5.3–5.4), the release of alkaline ions from the BGs balanced that out and brought the pH back to 6.0. Cytotoxicity tests performed on fibroblasts showed that the PCL-PGS-BGs constructs were biocompatible, with cell viability of above 125% at day 2. This study demonstrates the fabrication of systems with engineered properties by the synergy of diverse technologies and materials (organic and inorganic) for potential applications in tendon and ligament tissue engineering.

scholarly journals The Role of 3D Printing in Medical Applications: A State of the Art

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Anna Aimar ◽  
Augusto Palermo ◽  
Bernardo Innocenti
Keyword(s):  
3D Printing ◽  
Three Dimensional ◽  
Patient Specific ◽  
Digital Information ◽  
Medical Implants ◽  
Medical Field ◽  
3D Printed ◽  
Pipe Dream ◽  
Manufacturing Technologies

Three-dimensional (3D) printing refers to a number of manufacturing technologies that generate a physical model from digital information. Medical 3D printing was once an ambitious pipe dream. However, time and investment made it real. Nowadays, the 3D printing technology represents a big opportunity to help pharmaceutical and medical companies to create more specific drugs, enabling a rapid production of medical implants, and changing the way that doctors and surgeons plan procedures. Patient-specific 3D-printed anatomical models are becoming increasingly useful tools in today’s practice of precision medicine and for personalized treatments. In the future, 3D-printed implantable organs will probably be available, reducing the waiting lists and increasing the number of lives saved. Additive manufacturing for healthcare is still very much a work in progress, but it is already applied in many different ways in medical field that, already reeling under immense pressure with regards to optimal performance and reduced costs, will stand to gain unprecedented benefits from this good-as-gold technology. The goal of this analysis is to demonstrate by a deep research of the 3D-printing applications in medical field the usefulness and drawbacks and how powerful technology it is.

Abstract 17031: Noninvasive CT-Based Hemodynamic Assessment Using 3D Printing and Virtual Functional Assessment Index

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kranthi K Kolli ◽  
Abdul Zahid ◽  
Alexandre Caprio ◽  
Patricia Xu ◽  
Robert Shepherd ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pressure Drop ◽  
3D Printing ◽  
Functional Assessment ◽  
Patient Specific ◽  
Fractional Flow ◽  
Flow Rates ◽  
Assessment Index ◽  
3D Printed

Background: Virtual functional assessment index (vFAI), an alternative approach for assessing hemodynamic significance of stenosis has been shown to enhance the diagnostic performance of coronary computed tomography angiography (CCTA) based on evaluating the area under pressure drop-flow curve for a stenosis. Previously, this was assessed via computational fluid dynamics. We investigated the evaluation of vFAI from CCTA images using 3D printing and an in vitro flow loop and its efficacy as compared to the invasively measured fractional flow reserve (FFR). Methods and Results: Eighteen patients with varying degrees of coronary artery disease who underwent non-invasive CCTA scans and invasive FFR of their left anterior descending coronary artery (LAD) were included. The LAD artery was segmented and reconstructed using Mimics (Materialise inc.,). The segmented models were then 3D printed using Carbon 3D printer (Carbon Inc.,) with rigid resins. An in vitro flow circulation system representative of invasive measurements in a cardiac catheterization laboratory was developed to experimentally evaluate the hemodynamic parameters of pressure and flow (Fig A). For each model, a range of physiological flow rates was applied by a peristaltic steady flow pump and titrated by a flow sensor. The pressure drop and the pressure ratio (Pd/Pa) were assessed for patient-specific aortic pressure and differing flow rates. vFAI was evaluated as the normalized area under the P d /P a vs Q curve from 0 to 240 mL/min. There was a strong correlation between vFAI and FFR, (R = 0.83, p < 0.001; Fig B) and a very good agreement between the two parameters by Bland-Altman analysis. The mean difference of measurements from the two methods was 0.06 (SD = 0.08, p=0.0063; Fig C), indicating a small systematic overestimation of the FFR by vFAI. Conclusions: vFAI can be effectively derived from 3D CTCA datasets using 3D-printed in vitro models, based on evaluation over a range of hemodynamic conditions.

scholarly journals A review and guide to creating patient specific 3D printed anatomical models from MRI for benign gynecologic surgery

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Teresa E. Flaxman ◽  
Carly M. Cooke ◽  
Olivier X. Miguel ◽  
Adnan M. Sheikh ◽  
Sukhbir S. Singh
Keyword(s):  
3D Printing ◽  
Clinical Benefit ◽  
Three Dimensional ◽  
Uterine Fibroids ◽  
3D Models ◽  
Gynecologic Surgery ◽  
Patient Specific ◽  
Mr Images ◽  
Adjacent Structures ◽  
3D Printed

Abstract Background Patient specific three-dimensional (3D) models can be derived from two-dimensional medical images, such as magnetic resonance (MR) images. 3D models have been shown to improve anatomical comprehension by providing more accurate assessments of anatomical volumes and better perspectives of structural orientations relative to adjacent structures. The clinical benefit of using patient specific 3D printed models have been highlighted in the fields of orthopaedics, cardiothoracics, and neurosurgery for the purpose of pre-surgical planning. However, reports on the clinical use of 3D printed models in the field of gynecology are limited. Main text This article aims to provide a brief overview of the principles of 3D printing and the steps required to derive patient-specific, anatomically accurate 3D printed models of gynecologic anatomy from MR images. Examples of 3D printed models for uterine fibroids and endometriosis are presented as well as a discussion on the barriers to clinical uptake and the future directions for 3D printing in the field of gynecological surgery. Conclusion Successful gynecologic surgery requires a thorough understanding of the patient’s anatomy and burden of disease. Future use of patient specific 3D printed models is encouraged so the clinical benefit can be better understood and evidence to support their use in standard of care can be provided.

scholarly journals The use of three-dimensional anatomical patient-specific printed models in surgical clipping of intracranial aneurysm: A pilot study

2020 ◽  
Vol 11 ◽  
pp. 381
Author(s):  
Moneer K. Faraj ◽  
Samer S. Hoz ◽  
Amjad J. Mohammad
Keyword(s):  
3D Printing ◽  
Teaching Hospital ◽  
Three Dimensional ◽  
3D Models ◽  
Patient Specific ◽  
Anterior Communicating Artery ◽  
Parent Vessel ◽  
Microsurgical Clipping ◽  
Valuable Adjunct ◽  
3D Printed

Background: In the present study, we aim to develop simulation models based on computed tomography angiography images of intracranial aneurysms (IAs) and their parent vessels using three-dimensional (3D) printing technology. The study focuses on the value of these 3D models in presurgical planning and intraoperative navigation and ultimately their impact on patient outcomes. To the best of our knowledge, this is the first report of its kind from a war-torn country, like Iraq. Methods: This is a prospective study of a series of 11, consecutively enrolled, patients suffering from IAs for the period between February and September 2019. The study represents a collaboration between the two major neurosurgical centers in Baghdad/Iraq; Neurosciences Teaching Hospital and Neurosurgery Teaching Hospital. We analyzed the data of eleven patients with IAs treated by microsurgical clipping. These data include patient demographics, clinical, surgical, and outcomes along with the data of the 3D-printed replica used in these surgeries. All cases were operated on by one surgeon. Results: Our study included 11 patients, with a total of 11 aneurysms clipped. The mean age was 44 ± 8, with a median of 42.5 and a range of 35–61 years. About 60% of our patients were female with a female-to-male ratio of 1:5. About 60% of the aneurysms were located at the anterior communicating artery (Acom) while the remaining 40% were equally distributed between the posterior communicating and internal carotid arteries bifurcation. The standard pterional approach was followed in 50% of cases, whereas the other 50% of patients were treated through the lateral supraorbital approach. About 90% (n = 9) of the patients had a Glasgow Outcome Scale (GOS) of 5 and 10% had a GOS of 4. The 3D-printed models successfully replicated the aneurysm size, location, and relation to the parent vessel with 100% accuracy and were used for intraoperative guidance. The average production time was 24–48 h and the production cost was 10–20 US dollars. Conclusion: 3D printing is a promising technology that is rapidly penetrating the field of neurosurgery. In particular, the use of 3D-printed patient-matched, anatomically accurate replicas of the cerebral vascular tree is valuable adjunct to the microsurgical clipping of IAs, and our study conclusions support this concept. However, both the feasibility and clinical utility of 3D printing remain the subject of much, ongoing investigations.

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