3-Dimensional personalized planning for transcatheter pulmonary valve implantation in a dysfunctional right ventricular outflow tract
| Autor: | Emiliano Votta, Alberto Redaelli, Luca Giugno, Francesco Sturla, Mario Carminati, Alessandro Caimi, Francesca R Pluchinotta, Massimo Chessa, Alessandro Giamberti |
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| Rok vydání: | 2020 |
| Předmět: |
Cardiac Catheterization
medicine.medical_specialty 3D-printing Percutaneous Heart Ventricles medicine.medical_treatment Diastole 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine 3D interventional planning Region of interest medicine.artery medicine Humans Ventricular outflow tract Transcatheter pulmonary valve implantation 030212 general & internal medicine Innovation Computed tomography Cardiac catheterization Heart Valve Prosthesis Implantation Pulmonary Valve medicine.diagnostic_test Cardiac cycle business.industry Treatment Outcome Heart Valve Prosthesis Angiography Pulmonary artery Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | International Journal of Cardiology. 309:33-39 |
| ISSN: | 0167-5273 |
| Popis: | Background Identification of adequate landing zone for transcatheter pulmonary valve implantation (TPVI) is crucial to successfully treat an aneurysmatic native right ventricle outflow tract (RVOT); three-dimensional (3D) patient-tailored digital and physical printed models are available but their actual strengths and weaknesses still not well documented. The aim of the study was to tackle TPVI planning in the dysfunctional and borderline RVOT exploiting both digital and physical printed 3D patient-specific models. Methods Electrocardiographically gated computed tomography (CT) angiography was segmented and anatomical RVOT geometrical changes dynamically tracked throughout the cardiac cycle using in-house processing. A compliant 3D-printed model was manufactured from the diastolic rest phase to test in vitro the catheter-based procedure feasibility; results were compared against CT-derived in vivo measurements and the actual catheterization outcome. Results CT-gated analysis successfully quantified in vivo RVOT dynamic changes corroborating the feasibility of non-conventional pulmonary jailing percutaneous intervention. Clinicians used the 3D-printed model to test the steps of the jailing procedure; yet, the deformable 3D model printed at diastole underestimated the final implant dimensions obtained during cardiac catheterization by the same operators. Conclusions Multidisciplinary synergy between CT-gated analysis and pre-procedural tests on 3D-printed phantoms can help the interventional team to tackle complex TPVI procedures. To fully exploit 3D-printed models, adequate selection of the still frame to print and tuning of printing material properties is crucial and can be aided by 3D dynamic virtual models. |
| Databáze: | OpenAIRE |
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