Three-dimensional printing of atrial septal defect from echocardiographic images: feasibility, fidelity and potential applications

Abstract

Objectives —We sought to investigate the technical feasibility, fidelity and the potential applications of three-dimensional(3D) printed atrial septal defect (ASD) models based on three-dimensional transesophageal echocardiography (3D-TEE) images preliminarily. Methods—We retrospectively collected 40 ASD patients’ 3D-TEE images. The 3D-TEE data were imported into post-processing software to create printable 3D digital models, the patient-specific models were then printed by the 3D printer. Fidelity of the 3D printed models were quantitatively evaluated by comparing the measurements from 3D ASD models and echocardiographic data. Results —Ultrasound-derived 3D ASD models were acquired in all the forty cases successfully. There was good consistency and no significant differences in ASD size parameters among 3D printed models, 2D-TEE images and 3D-TEE images（all P>0.05）. Also, it showed small difference among 3D printed models, 2D-TEE images and 3D-TEE images in the absolute difference value of ASD size parameters. There’s a highly significant correlation between the ASD parameters including the maximal diameter, the minimal diameter and circumference measured by 3D ASD printed models and the corresponding parameters of ASD occluders applied in actual surgical procedure. Simulation exercises in the 3D ASD printed models had an impressive effect based on the comprehensive assessment of the ASD parameters. Conclusions—It is feasible to use 3D-TEE images as the data source of ASD 3D printed models. Ultrasound-derived ASD 3D printed models show highly fidelity, which contributes to provide evidence for the clinical application of 3D printing technology in decision of ASD occlusion.