Richard L Izzo1,2, Ryan P O'Hara1,2, Vijay Iyer1,3, Rose Hansen3, Karen M Meess1,2, S V Setlur Nagesh4, Stephen Rudin4, Adnan H Siddiqui1,5, Michael Springer1, Ciprian N Ionita2,4. 1. The Jacobs Institute, 875 Ellicott Street, 5 Floor, Buffalo, NY. 2. Biomedical Engineering, University at Buffalo, 332 Bonner Hall, Buffalo, NY. 3. Interventional Cardiology, University at Buffalo, 875 Ellicott Street, Suite 7030, Buffalo, NY. 4. Toshiba Stroke and Vascular Research Center, 875 Ellicott Street, 8 Floor, Buffalo, NY. 5. University at Buffalo Neurosurgery, 100 High Street, Section B4, Buffalo, NY.
Abstract
3D printing an anatomically accurate, functional flow loop phantom of a patient's cardiac vasculature was used to assist in the surgical planning of one of the first native transcatheter mitral valve replacement (TMVR) procedures. CTA scans were acquired from a patient about to undergo the first minimally-invasive native TMVR procedure at the Gates Vascular Institute in Buffalo, NY. A python scripting library, the Vascular Modeling Toolkit (VMTK), was used to segment the 3D geometry of the patient's cardiac chambers and mitral valve with severe stenosis, calcific in nature. A stereolithographic (STL) mesh was generated and AutoDesk Meshmixer was used to transform the vascular surface into a functioning closed flow loop. A Stratasys Objet 500 Connex3 multi-material printer was used to fabricate the phantom with distinguishable material features of the vasculature and calcified valve. The interventional team performed a mock procedure on the phantom, embedding valve cages in the model and imaging the phantom with a Toshiba Infinix INFX-8000V 5-axis C-arm bi-Plane angiography system. RESULTS: After performing the mock-procedure on the cardiac phantom, the cardiologists optimized their transapical surgical approach. The mitral valve stenosis and calcification were clearly visible. The phantom was used to inform the sizing of the valve to be implanted. CONCLUSION: With advances in image processing and 3D printing technology, it is possible to create realistic patient-specific phantoms which can act as a guide for the interventional team. Using 3D printed phantoms as a valve sizing method shows potential as a more informative technique than typical CTA reconstruction alone.
3D printing an anatomically accurate, functional flow loop phantom of a patient's cardiac vasculature was used to assist in the surgical planning of one of the first native transcatheter mitral valve replacement (TMVR) procedures. CTA scans were acquired from a patient about to undergo the first minimally-invasive native TMVR procedure at the Gates Vascular Institute in Buffalo, NY. A python scripting library, the Vascular Modeling Toolkit (VMTK), was used to segment the 3D geometry of the patient's cardiac chambers and mitral valve with severe stenosis, calcific in nature. A stereolithographic (STL) mesh was generated and AutoDesk Meshmixer was used to transform the vascular surface into a functioning closed flow loop. A Stratasys Objet 500 Connex3 multi-material printer was used to fabricate the phantom with distinguishable material features of the vasculature and calcified valve. The interventional team performed a mock procedure on the phantom, embedding valve cages in the model and imaging the phantom with a Toshiba Infinix INFX-8000V 5-axis C-arm bi-Plane angiography system. RESULTS: After performing the mock-procedure on the cardiac phantom, the cardiologists optimized their transapical surgical approach. The mitral valve stenosis and calcification were clearly visible. The phantom was used to inform the sizing of the valve to be implanted. CONCLUSION: With advances in image processing and 3D printing technology, it is possible to create realistic patient-specific phantoms which can act as a guide for the interventional team. Using 3D printed phantoms as a valve sizing method shows potential as a more informative technique than typical CTA reconstruction alone.
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Authors: Kelsey Sommer; Richard L Izzo; Lauren Shepard; Alexander R Podgorsak; Stephen Rudin; Adnan H Siddiqui; Michael F Wilson; Erin Angel; Zaid Said; Michael Springer; Ciprian N Ionita Journal: Proc SPIE Int Soc Opt Eng Date: 2017-03-13
Authors: Martin L Tomov; Alexander Cetnar; Katherine Do; Holly Bauser-Heaton; Vahid Serpooshan Journal: J Am Heart Assoc Date: 2019-12-10 Impact factor: 5.501
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Authors: Kelsey N Sommer; Lauren Shepard; Nitant Vivek Karkhanis; Vijay Iyer; Erin Angel; Michael F Wilson; Frank J Rybicki; Dimitrios Mitsouras; Stephen Rudin; Ciprian N Ionita Journal: Proc SPIE Int Soc Opt Eng Date: 2018-03-12