Silicone models of the aortic root to plan and simulate interventions

Application of three-dimensional printing in cardiovascular diseases: a bibliometric analysis

AIM

This paper aimed to explore the application of three-dimensional (3D) printing in cardiovascular diseases, to reach an insight in this field and prospect the future trend.

METHODS

The articles were selected from the Web of Science Core Collection database. Excel 2019, VOSviewer 1.6.16, and CiteSpace 6.1.R6 were used to analyze the information.

RESULTS

A total of 467 papers of 3D printing in cardiovascular diseases were identified, and the first included literature appeared in 2000. A total of 692 institutions from 52 countries participated in the relevant research, while the United States of America contributed to 160 articles and were in a leading position. The most productive institution was Curtin University , and Zhonghua Sun who has posted the most articles ( n =8) was also from there. The Frontiers in Cardiovascular Medicine published most papers ( n =25). The Journal of Thoracic and Cardiovascular Surgery coveted the most citations ( n =520). Related topics of frontiers will still focus on congenital heart disease, valvular heart disease, and left atrial appendage closure.

CONCLUSIONS

The authors summarized the publication information of the application of 3D printing in cardiovascular diseases related literature from 2000 to 2023, including country and institution of origin, authors, and publication journal. This study can reflect the current hotspots and novel directions for the application of 3D printing in cardiovascular diseases.

A soft functional mitral valve model prepared by three-dimensional printing as an aid for an advanced mitral valve operation

OBJECTIVES

The goal of this study was to build a soft mitral valve (MV) model for surgical simulation to aid with an advanced MV operation.

METHODS

Soft three-dimensional models of the MV were constructed by the mould-modelling method using silicone. The properties of the material used were tested and compared with those of the valve tissue. Then, the accuracy of the three-dimensional model was assessed from the perspectives of the pathological and morphological parameters. Thereafter, surgical simulation of MV repair, closure of the perforation and transcatheter MV replacement were simulated using our model. Two experienced surgeons were invited to perform and evaluate the fidelity and softness of the model. Morphological changes in the MV and the potential compression of the device on surrounding cardiac tissue were also measured after simulation.

RESULTS

The soft MV model was successfully constructed by the mould-modelling method. The property of the material used was closer to that of valve tissue than to that of the rigid model. In addition, the pathological details and morphological measurements of the three-dimensional model were consistent with the surgical findings. The simulated surgical procedure was successful using our model. Morphological changes, including the ratio of the leaflet/annulus area and the coaptation depth, were closely correlated with the regurgitation left after MV repair, which might be an indicator of the surgical effects. The results of this study demonstrated the great advantages of our constructed soft model in exploring the interaction of the device with the surrounding tissue. These advantages were not obtained using the rigid model in a previous study.

CONCLUSIONS

The soft MV model was successfully constructed using the mould-modelling method, and its physical properties were similar to those of heart tissue. In addition, the constructed model exhibited great advantages in surgical simulation and clinical application compared with the anatomical model.

Unprecedented Strength Polysiloxane-Based Polyurethane for 3D Printing and Shape Memory

Thermoplastic polysiloxane-based polyurethane (Si-TPU) has been attracting a great deal of attention because of the dual advantages of polysiloxane and polyurethane. However, the strength of Si-TPU with a traditional structure is low, and improvement is urgently needed for diverse applications. Herein, we design a polysiloxane-based soft segment (SS) with two urethane groups at the end of the polysiloxane chain, and then we prepare a series of Si-TPUs through a designed SS, isophorone diisocyanate and 1,4-butanediol. Such structural design improves the polarity of the SS and endows more regular hydrogen bonds to the polymer molecular chain. As a result, the prepared Si-TPUs exhibit a good microphase separation structure, unprecedentedly high strength, repeatable processing, noncytotoxicity, shape memory properties, and three-dimensional printing capabilities. Moreover, a maximum tensile strength of Si-TPUs can reach 20.3 MPa, exceeding that of other existing Si-based polymer materials. Si-TPUs show great potential for biomedical applications.

State-of-the-Art Silicone Molded Models for Simulation of Arterial Switch Operation: Innovation with Parting-and-Assembly Strategy

Background

Methods

Results

Conclusions

Novel Resectable Myocardial Model Using Hybrid Three-Dimensional Printing and Silicone Molding for Mock Myectomy for Apical Hypertrophic Cardiomyopathy

Objective

We implemented a novel resectable myocardial model for mock myectomy using a hybrid method of three-dimensional (3D) printing and silicone molding for patients with apical hypertrophic cardiomyopathy (ApHCM).

Materials and Methods

From January 2019 through May 2020, 3D models from three patients with ApHCM were generated using the end-diastolic cardiac CT phase image. After computer-aided designing of measures to prevent structural deformation during silicone injection into molding, 3D printing was performed to reproduce anatomic details and molds for the left ventricular (LV) myocardial mass. We compared the myocardial thickness of each cardiac segment and the LV myocardial mass and cavity volumes between the myocardial model images and cardiac CT images. The surgeon performed mock surgery, and we compared the volume and weight of the resected silicone and myocardium.

Results

During the mock surgery, the surgeon could determine an ideal site for the incision and the optimal extent of myocardial resection. The mean differences in the measured myocardial thickness of the model (0.3, 1.0, 6.9, and 7.3 mm in the basal, midventricular, apical segments, and apex, respectively) and volume of the LV myocardial mass and chamber (36.9 mL and 14.8 mL, 2.9 mL and −9.4 mL, and 6.0 mL and −3.0 mL in basal, mid-ventricular and apical segments, respectively) were consistent with cardiac CT. The volume and weight of the resected silicone were similar to those of the resected myocardium (6 mL [6.2 g] of silicone and 5 mL [5.3 g] of the myocardium in patient 2; 12 mL [12.5 g] of silicone and 11.2 mL [11.8 g] of the myocardium in patient 3).

Conclusion

Our 3D model created using hybrid 3D printing and silicone molding may be useful for determining the extent of surgery and planning surgery guided by a rehearsal platform for ApHCM.