The use of 3D printing in cardiac surgery

Ong, Chin Siang; Hibino, Narutoshi

doi:10.21037/jtd.2017.07.73

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…Our study results suggest that VR can be a useful adjunct in traditional presurgical planning methods, an observation also echoed by other studies in this domain which highlight the potential for group-based approaches, user-defined interactive views, and cost-effectiveness over 3D printing [13,14].…”

Section: Discussionsupporting

confidence: 77%

Advancing Cardiac Surgery Case Planning and Case Review Conferences Using Virtual Reality in Medical Libraries: Evaluation of the Usability of Two Virtual Reality Apps

2019

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BackgroundCare providers and surgeons prepare for cardiac surgery using case conferences to review, discuss, and run through the surgical procedure. Surgeons visualize a patient’s anatomy to decide the right surgical approach using magnetic resonance imaging and echocardiograms in a presurgical case planning session. Previous studies have shown that surgical errors can be reduced through the effective use of immersive virtual reality (VR) to visualize patient anatomy. However, inconsistent user interfaces, delegation of view control, and insufficient depth information cause user disorientation and interaction difficulties in using VR apps for case planning.ObjectiveThe objective of the study was to evaluate and compare the usability of 2 commercially available VR apps—Bosc (Pyrus Medical systems) and Medical Holodeck (Nooon Web & IT GmbH)—using the Vive VR headset (HTC Corporation) to evaluate ease of use, physician attitudes toward VR technology, and viability for presurgical case planning. The role of medical libraries in advancing case planning is also explored.MethodsAfter screening a convenience sample of surgeons, fellows, and residents, ethnographic interviews were conducted to understand physician attitudes and experience with VR. Gaps in current case planning methods were also examined. We ran a usability study, employing a concurrent think-aloud protocol. To evaluate user satisfaction, we used the system usability scale (SUS) and the National Aeronautics and Space Administration-Task Load Index (NASA-TLX). A poststudy questionnaire was used to evaluate the VR experience and explore the role of medical libraries in advancing presurgical case planning. Semistructured interview data were analyzed using content analysis with feedback categorization.ResultsParticipants were residents, fellows, and surgeons from the University of Washington with a mean age of 41.5 (SD 11.67) years. A total of 8 surgeons participated in the usability study, 3 of whom had prior exposure to VR. Users found Medical Holodeck easier to use than Bosc. Mean adjusted NASA-TLX score for Medical Holodeck was 62.71 (SD 18.25) versus Bosc’s 40.87 (SD 13.90). Neither app passed the mean SUS score of 68 for an app to be considered usable, though Medical Holodeck (66.25 [SD 12.87]) scored a higher mean SUS than Bosc (37.19 [SD 22.41]). One user rated the Bosc usable, whereas 3 users rated Medical Holodeck usable.ConclusionsInterviews highlighted the importance of precise anatomical conceptualization in presurgical case planning and teaching, identifying it as the top reason for modifying a surgical procedure. The importance of standardized user interaction features such as labeling is justified. The study also sheds light on the new roles medical librarians can play in curating VR content and promoting interdisciplinary collaboration.

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Section: Discussionsupporting

confidence: 77%

Advancing Cardiac Surgery Case Planning and Case Review Conferences Using Virtual Reality in Medical Libraries: Evaluation of the Usability of Two Virtual Reality Apps

2019

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“…3D printing is an advanced type of medical manufacturing, in which machines use imaging technology to design a specific part of the patient's body. In specific, following a specialized process of analyzing a CT and segmenting the anatomy and by the support of a very advanced 3D printer and postprocessing software, an accurate 3D model is manufactured, which is an exact replica of the organ under evaluation 8 …”

Section: Discussionmentioning

confidence: 99%

“…In specific, following a specialized process of analyzing a CT and segmenting the anatomy and by the support of a very advanced 3D printer and postprocessing software, an accurate 3D model is manufactured, which is an exact replica of the organ under evaluation. 8 Having constructed the anatomical model via 3D printing and knowing the exact dimensions and shape of the trachea provided, we simulated the intubation of the model with a fiberoptic bronchoscope. Based on this simulation, we were able to decide that the most appropriate course of action for securing the airway in this particular patient would be to resort to fiberoptic intubation to overcome the obstacle of a deviated and stenotic trachea.…”

Section: Discussionmentioning

confidence: 99%

Secondary tracheal distortion in an adult patient after therapy for diphtheria at childhood

et al. 2020

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We report a rare case of difficult intubation because of trachea deformation after therapy for diphtheria and subsequent tracheostomy at childhood. The patient was admitted to be subjected to a Bentall procedure, because of ascending aorta dilatation. With a detailed preanesthetic assessment and simulation for intubation by using three-dimensional technology, he was successfully intubated and the operation was accomplished uneventfully. 3D-printed models of the difficult airway enhance imaging of difficult anatomy, assist in simulation and management of potentially problematic intubation, and can be a valuable tool when dealing with airways with potential anatomical malformations. K E Y W O R D S 3D printing, fiberoptic intubation, tracheal distortion, tracheal stenosis How to cite this article: Antoniou T, Papadopoulos K, Kampanarou S, Ftikos P, Perreas K, Theodoraki K. Secondary tracheal distortion in an adult patient after therapy for diphtheria at childhood.

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“…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].…”

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 use of 3D printing in cardiac surgery

Cited by 5 publications

References 15 publications

Advancing Cardiac Surgery Case Planning and Case Review Conferences Using Virtual Reality in Medical Libraries: Evaluation of the Usability of Two Virtual Reality Apps

Advancing Cardiac Surgery Case Planning and Case Review Conferences Using Virtual Reality in Medical Libraries: Evaluation of the Usability of Two Virtual Reality Apps

Secondary tracheal distortion in an adult patient after therapy for diphtheria at childhood

Recent Applications of Three Dimensional Printing in Cardiovascular Medicine

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