Three-Dimensional Heart Modeling of Hypertrophic Obstructive Cardiomyopathy for In Situ Patient-Specific Simulation to Optimize Septal Myectomy.

Autor:	Smits KC; Department of Cardiothoracic Surgery, Thorax Centrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands.; Department of Biomechanical Engineering, Faculty of Engineering Technology, TechMed Centre, University of Twente, Enschede, The Netherlands.; Department of Physiology and Cardiology, Maastricht University Medical Centre, The Netherlands., Speekenbrink RGH; Department of Cardiothoracic Surgery, Thorax Centrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands., Hekman EEG; Department of Biomechanical Engineering, Faculty of Engineering Technology, TechMed Centre, University of Twente, Enschede, The Netherlands., Koenrades MA; Medical 3D Lab, Medisch Spectrum Twente, Enschede, The Netherlands.; Multi-Modality Medical Imaging (M3i) Group, Faculty of Science and Technology, TechMed Centre, University of Twente, Enschede, The Netherlands., Heeringa TJP; Department of Cardiothoracic Surgery, University Medical Centre Utrecht, The Netherlands., Arens J; Department of Biomechanical Engineering, Faculty of Engineering Technology, TechMed Centre, University of Twente, Enschede, The Netherlands., Halfwerk FR; Department of Cardiothoracic Surgery, Thorax Centrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands.; Department of Biomechanical Engineering, Faculty of Engineering Technology, TechMed Centre, University of Twente, Enschede, The Netherlands.
Jazyk:	angličtina
Zdroj:	Innovations (Philadelphia, Pa.) [Innovations (Phila)] 2024 Sep-Oct; Vol. 19 (5), pp. 532-540. Date of Electronic Publication: 2024 Sep 02.
DOI:	10.1177/15569845241273538
Abstrakt:	Objective: Hypertrophic obstructive cardiomyopathy (HOCM) develops in at least 1 out of 715 young adults. Patients who are refractory to medical therapy qualify for septal myectomy. Due to anatomy, serious complications such as ventricular septal defect and heart block may occur. Establishing cardiovascular magnetic resonance (CMR)-based 3-dimensional (3D) models as part of preoperative planning and training has the potential to decrease procedure-related complications and improve results. Methods: CMR images were used to segment cardiac structures. Left ventricular wall thickness was calculated and projected on top of the in silico model. A 3D model was printed with a red layer indicating a wall thickness exceeding 15 mm and used for preoperative resection planning and patient counseling. To provide preoperative patient-specific in situ simulation, the planned resection volume was replaced with silicone in a second model. For perioperative quality control, resected silicone was compared with resected myocardial tissue. The impact of the models was evaluated descriptively through consultation of both the cardiothoracic surgeon and patients and through patient outcomes. Results: Three-dimensional in silico and 3D-printed heart models of 5 patients were established preoperatively. Since the introduction of the models in October 2020, the surgeon feels better prepared, more confident, and less difficulty with making decisions. In addition, patients feel better informed preoperatively. Conclusions: Using 3D heart models optimized preoperative planning and training, intraoperative quality control, and patient consultation. Reduction of procedure-related complications and clinical outcome should be studied in larger cohorts. Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu