Preliminary study on the application of mitral valve prolapse model made by three-dimensional printing in mitral valvuloplasty

Abstract

Objective To evaluate the feasibility and accuracy of mitral valve prolapse(MVP) model made by three-dimensional(3D) printing based on three-dimensional transesophageal echocardiography(3D-TEE) data and the application value for mitral valvuloplasty. Methods 3D-TEE volumetric data of 28 patients with MVP were acquired and postprocessed, 13 patients underwent mitral valve replacement and 15 patients underwent mitral valvuloplasty. A flexible material was used to made the valve 3D model by molding. The areas of MVP identified by models were compared with surgical findings, the circumference and the length and thickness of anterior and posterior mitral leaflets obtained from the valve specimens and the models were compared in the mitral valve replacement group. The diameter between anterior and posterior, the diameter between anterolaterior and posteromedial, annulus area, height of prolapsed leaflet and area of prolapsed leaflet were measured from 3D models and 3D-TEE images in mitral valvuloplasty group. Surgical simulations were performed on the 3D models of the mitral valvuloplasty group, and the water injection test was used to evaluate the surgical results and compared with the surgical results. Results 3D-TEE volumetric data were successfully postprocessed and made as 3D MVP models in all patients. The consistency of MVP location based on 3D models and surgical findings was 0.92. The differences between the mitral valve replacement group and mitral valvuloplasty group were not significant (P>0.05). A simulation valvuloplasty was successfully performed on the 3D model in mitral valvuloplasty group, 2 patients underwent mitral valve replacement after water injection test. The remaining 3D models successfully simulated the operation. Conclusions The MVP model made by 3D-TEE and 3D printing technique has high feasibility and accuracy, which may be promising for the mitral valvuloplasty of MVP. Key words: Echocardiography, transesophageal, three-dimensional; Three-dimensional printing; Mitral valve prolapse; Mitral valvuloplasty