Flexible and comprehensive patient-specific mitral valve silicone models with chordae tendineae made from 3D-printable molds

Engelhardt, Sandy; Sauerzapf, Simon; Preim, Bernhard; Kretzler, Matthias; Wolf, Ivo; Simone, Raffaele De

doi:10.1007/s11548-019-01971-9

Cited by 45 publications

(41 citation statements)

References 19 publications

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“…In addition to the directly 3D-printed medical or pharmaceutical products, this technology can also be used for the 3D-printing of individual molds [ 111 , 112 , 113 , 114 ]. Thus, beneficial freedom for the desired shape can be combined with materials that are unsuitable for direct 3D-printing at present or can be further implemented in manufacturing procedures or development steps.…”

Section: Current Medical and Pharmaceutical Applications Of 3d-printingmentioning

confidence: 99%

3D-Printing of Drug-Eluting Implants: An Overview of the Current Developments Described in the Literature

Domsta

Seidlitz

2021

Molecules

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The usage of 3D-printing for drug-eluting implants combines the advantages of a targeted local drug therapy over longer periods of time at the precise location of the disease with a manufacturing technique that easily allows modifications of the implant shape to comply with the individual needs of each patient. Research until now has been focused on several aspects of this topic such as 3D-printing with different materials or printing techniques to achieve implants with different shapes, mechanical properties or release profiles. This review is intended to provide an overview of the developments currently described in the literature. The topic is very multifaceted and several of the investigated aspects are not related to just one type of application. Consequently, this overview deals with the topic of 3D-printed drug-eluting implants in the application fields of stents and catheters, gynecological devices, devices for bone treatment and surgical screws, antitumoral devices and surgical meshes, as well as other devices with either simple or complex geometry. Overall, the current findings highlight the great potential of the manufacturing of drug-eluting implants via 3D-printing technology for advanced individualized medicine despite remaining challenges such as the regulatory approval of individualized implants.

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Section: Current Medical and Pharmaceutical Applications Of 3d-printingmentioning

confidence: 99%

3D-Printing of Drug-Eluting Implants: An Overview of the Current Developments Described in the Literature

Domsta

Seidlitz

2021

Molecules

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“…Over the last years, 3D printing has been demonstrated particularly helpful in the pre-surgical planning of minimally invasive procedures, such as mitral valve (MV) repair surgery [31][32][33]. Minimally invasive procedures are considered as very complicated, and reconstructive MV surgery is particularly challenging due to variation in valve pathologies.…”

Section: D Printing For Teaching and Surgical Training In Cardiovascmentioning

confidence: 99%

“…The authors stated that the material properties of such models facilitated functional evaluation of novel trans-catheter MV repair strategies, thus providing surgeons a realistic tool for surgical training [31]. More recently, Engelhardt and colleagues produced for the first time 3D printed MV silicone models containing the full MV apparatus of specific patients, that is the annulus, leaflets, chordae tendineae, and papillary muscles [33]. Then, twelve surgeons performed various surgical techniques, such as annuloplasty, neo-chordae implantation, and triangular leaflet resection, judging the realism of the valves very positively.…”

Section: D Printing For Teaching and Surgical Training In Cardiovascmentioning

confidence: 99%

Recent Applications of Three Dimensional Printing in Cardiovascular Medicine

Gardin

Ferroni

Latrémouille

et al. 2020

Cells

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Three dimensional (3D) printing, which consists in the conversion of digital images into a 3D physical model, is a promising and versatile field that, over the last decade, has experienced a rapid development in medicine. Cardiovascular medicine, in particular, is one of the fastest growing area for medical 3D printing. In this review, we firstly describe the major steps and the most common technologies used in the 3D printing process, then we present current applications of 3D printing with relevance to the cardiovascular field. The technology is more frequently used for the creation of anatomical 3D models useful for teaching, training, and procedural planning of complex surgical cases, as well as for facilitating communication with patients and their families. However, the most attractive and novel application of 3D printing in the last years is bioprinting, which holds the great potential to solve the ever-increasing crisis of organ shortage. In this review, we then present some of the 3D bioprinting strategies used for fabricating fully functional cardiovascular tissues, including myocardium, heart tissue patches, and heart valves. The implications of 3D bioprinting in drug discovery, development, and delivery systems are also briefly discussed, in terms of in vitro cardiovascular drug toxicity. Finally, we describe some applications of 3D printing in the development and testing of cardiovascular medical devices, and the current regulatory frameworks that apply to manufacturing and commercialization of 3D printed products.Cells 2020, 9, 742 2 of 33 Cells 2020, 9, 742 3 of 33 in digital modeling softwares without the need for file type conversion [16]. Several medical image segmentation softwares are available; some of these are open-source and freely accessible, while others are commercial, licensed products. From the DICOM dataset, the target anatomic geometry is identified and segmented based on properties such as contrast or brightness [17]. As a result, segmentation masks are created such that pixels with the same intensity range are grouped and converted into 3D digital models using rendering techniques. These segmented digital models are then exported out in the standard tessellation language (STL) file type, which is the industry standard for 3D objects and 3D printing software [17]. Nevertheless, STL files do not contain color information and in order to print in multiple colors, a different file format will need to be used. For example, virtual reality modeling language (VRML) and additive manufacturing file format (AMF) provide multiple color and material options [18]. Once segmentation is completed, the final 3D digital model may be further modified within computer-aided design (CAD) software. The main post-processing adjustments of the 3D model are: Repairing errors and discontinuities that sometimes arise in the image segmentation and exporting processes, smoothing of the surface of the model due to scaling errors resulting from the resolution of the original medical image, and addition of other...

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“…The methods for precise modelling of intracardiac structures required certain practical assumptions and anatomic mapping decisions. Our models of the mitral valve chordae tendineae and papillary muscles were based on previously validated studies 21 – 23 . Furthermore, our collision model did not account for the intracardiac motion of the pacemaker and assumed it would maintain a consistent perpendicular position against the endocardial wall during cardiac contraction.…”

Section: Limitationsmentioning

confidence: 99%

Tracking the motion of intracardiac structures aids the development of future leadless pacing systems

Razeghi

Strocchi

Lee

et al. 2020

Cardiovasc electrophysiol

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Background Leadless pacemakers preclude the need for permanent leads to pace endocardium. However, it is yet to be determined whether a leadless pacemaker of a similar design to those manufactured for the right ventricle (RV) fits within the left ventricle (LV), without interfering with intracardiac structures. Methods Cardiac computed tomography scans were obtained from 30 patients indicated for cardiac resynchronisation therapy upgrade. The mitral valve annulus, chordae tendineae, papillary muscles and LV endocardial wall were marked in the end‐diastolic frame. Intracardiac structures motions were tracked through the cardiac cycle. Two pacemaker designs similar to commercially manufactured leadless systems (Abbott's Nanostim LCP and Medtronic's Micra TPS) as well as theoretical designs with calculated optimal dimensions were evaluated. Pacemakers were virtually placed across the LV endocardial surface and collisions between them and intracardiac structures were detected throughout the cycle. Results Probability maps of LV intracardiac structures collisions on a 16‐segment AHA model indicated possible placement for the Nanostim LCP, Micra TPS, and theoretical designs. Thresholding these maps at a 20% chance of collision revealed only about 36% of the endocardial surface remained collision‐free with the deployment of Micra TPS design. The same threshold left no collision‐free surface in the case of the Nanostim LCP. To reach at least half of the LV endocardium, the volume of Micra TPS, which is the smaller design, needed to be decreased by 41%. Conclusion Due to the presence of intracardiac structures, placement of leadless pacemakers with dimensions similar to commercially manufactured RV systems would be limited to apical regions.

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Flexible and comprehensive patient-specific mitral valve silicone models with chordae tendineae made from 3D-printable molds

Cited by 45 publications

References 19 publications

3D-Printing of Drug-Eluting Implants: An Overview of the Current Developments Described in the Literature

3D-Printing of Drug-Eluting Implants: An Overview of the Current Developments Described in the Literature

Recent Applications of Three Dimensional Printing in Cardiovascular Medicine

Tracking the motion of intracardiac structures aids the development of future leadless pacing systems

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