Evaluating 3D-printed models of coronary anomalies: a survey among clinicians and researchers at a university hospital in the UK

Abstract

ObjectiveTo evaluate the feasibility of three-dimensional (3D) printing models of coronary artery anomalies based on cardiac CT data and explore their potential for clinical applications.DesignCardiac CT datasets of patients with various coronary artery anomalies (n=8) were retrospectively reviewed and processed, reconstructing detailed 3D models to be printed in-house with a desktop 3D printer (Form 2, Formlabs) using white resin.SettingA University Hospital (division of cardiology) in the UK.ParticipantsThe CT scans, first and then 3D-printed models were presented to groups of clinicians (n=8) and cardiovascular researchers (n=9).InterventionParticipants were asked to assess different features of the 3D models and to rate the models’ overall potential usefulness.Outcome measuresModels were rated according to clarity of anatomical detail, insight into the coronary abnormality, overall perceived usefulness and comparison to CT scans. Assessment of model characteristics used Likert-type questions (5-point scale from ‘strongly disagree’ to ‘strongly agree’) or a 10-point rating (from 0, lowest, to 10, highest). The questionnaire included a feedback form summarising overall usefulness. Participants’ imaging experience (in a number of years) was also recorded.ResultsAll models were reconstructed and printed successfully, with accurate details showing coronary anatomy (eg, anomalous coronary artery, coronary roofing or coronary aneurysm in a patient with Kawasaki syndrome). All clinicians and researchers provided feedback, with both groups finding the models helpful in displaying coronary artery anatomy and abnormalities, and complementary to viewing 3D CT scans. The clinicians’ group, who had substantially more imaging expertise, provided more enthusiastic ratings in terms of models’ clarity, usefulness and future use on average.Conclusions3D-printed heart models can be feasibly used to recreate coronary artery anatomy and enhance understanding of coronary abnormalities. Future studies can evaluate their cost-effectiveness, as well as potentially explore other printing techniques and materials.

Clinical Applications of Patient-Specific 3D Printed Models in Cardiovascular Disease: Current Status and Future Directions

“…Another application of 3D printed coronary artery models is to improve understanding of coronary anomalies. Lee et al in this study selected eight cases with one normal coronary artery and seven diseased coronary arteries comprising different coronary abnormalities [ 58 ]. Eight patient-specific coronary models were created and presented to nine cardiovascular researchers and eight clinicians (two cardiac surgeons and six cardiologists) with the aim of seeking their feedback on the usefulness of 3D printed models.…”

Recent Applications of Three Dimensional Printing in Cardiovascular Medicine

“…This is especially true for certain rare congenital heart diseases (CHD), where each patient has a different intracardiac and extracardiac anatomy, such as the chest wall and the relation of the heart to the chest wall. In all these cases, 3D printed models can lead to better pre-operative planning [26,27]. Other advantages of training using 3D models include a reduction in operation time and the possibility to predict intra-operative complications and plan management as required [21].…”

A Novel Method to Adjust Saphenous Vein Graft Lengths Using 3D Printing Models

“…This gives the opportunity to make more realistic complex combined models [Kappanayil 2017]. Coronary segmentation and printing in coronary anomalies were done [Lee 2019], but native arteriosclerotic coronary segmentation and planning procedures on coronary arteries have not been performed. To the best of our knowledge, this is the first study to segment and print native coronary arteries for planning surgical revascularization.…”