Abstract
Three-dimensional (3D) printing has been increasingly used in medicine with applications in many different fields ranging from orthopaedics and tumours to cardiovascular disease. Realistic 3D models can be printed with different materials to replicate anatomical structures and pathologies with high accuracy. 3D printed models generated from medical imaging data acquired with computed tomography, magnetic resonance imaging or ultrasound augment the understanding of complex anatomy and pathology, assist preoperative planning and simulate surgical or interventional procedures to achieve precision medicine for improvement of treatment outcomes, train young or junior doctors to gain their confidence in patient management and provide medical education to medical students or healthcare professionals as an effective training tool. This article provides an overview of patient-specific 3D printed models with a focus on the applications in cardiovascular disease including: 3D printed models in congenital heart disease, coronary artery disease, pulmonary embolism, aortic aneurysm and aortic dissection, and aortic valvular disease. Clinical value of the patient-specific 3D printed models in these areas is presented based on the current literature, while limitations and future research in 3D printing including bioprinting of cardiovascular disease are highlighted.
Highlights
Three-dimensional (3D) printing is not a new technology, it has experienced rapid developments over the last decade with increasing studies available in the literature documenting its clinical value in different areas
Patient-specific or personalized 3D printed models accurately replicate normal anatomical structures and pathologies, serving as a valuable tool in medical applications ranging from the initial orthopaedics and maxillofacial domain to cardiovascular disease and tumours [1,2,3,4,5,6,7,8,9,10]. 3D printed physical models provide useful information in pre-operative planning and simulation of complex surgical procedures, education of medical students and residents, intraoperative orientation, and physician-patient communication [8,9,10,11,12,13,14]
Evidence of 3D printed models in these applications is dominated by case reports and case series, while multi-centre studies and randomized controlled trials (RCTs) are increasingly reported in the literature [15,16,17,18,19,20]. 3D printed models augment clinicians’ confidence in managing different clinical situations by improving their understanding of complex spatial relationship between the normal anatomy and pathologies which cannot be accurately achieved by the traditional image visualizations
Summary
Three-dimensional (3D) printing is not a new technology, it has experienced rapid developments over the last decade with increasing studies available in the literature documenting its clinical value in different areas. These preliminary reports along with others suggest the potential value of using 3D printed coronary or cardiac models for studying the optimal CT protocols, further research is needed to validate these findings [59,62,63]. Reprinted with permission under open access from Aldosari et al [84] These findings indicate the potential applications of 3D printed models in optimizing CT scanning protocols, in particular in the diagnostic detection of pulmonary embolism, given the fact that CTPA is the first line technique in the diagnosis of pulmonary embolism. These promising findings will need to be tested in vivo situations before bioprinted models can be applied to patients for treating cardiovascular disease
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