Soft tissue models: easy and inexpensive flexible 3D printing as a help in surgical planning of cardiovascular disorders

Abstract

We developed a technology that allows a simple desktop 3D printer with dual extruder to fabricate 3D flexible models of Major AortoPulmonary Collateral Arteries. The study was designed to assess whether the flexible 3D printed models could help during surgical planning phase. Simple FDM 3D printers are inexpensive, versatile in use and easy to maintain, but complications arise when the designed model is complex and has tubular structures with small diameter less than 2mm. The advantages of FDM printers are cost and simplicity of use. We use precisely selected materials to overcome the obstacles listed above. Dual extruder allows to use two different materials while printing, which is especially important in the case of fragile structures like pulmonary vessels and its supporting structures. The latter should not be removed by hand to avoid a truncation of the model. We utilize the water soluble PVA as a supporting structure and Poro-Lay filament for flexible model of AortoPulmonary collateral arteries. Poro-Lay filament is different as compared to all the other flexible ones like polymer-based. Poro-Lay is rigid while printing and this allows printing of structures small in diameter. It achieves flexibility after washing out of printed model with water. It becomes soft in touch and gelatinous. Using both PVA and Poro-Lay gives a huge advantage allowing to wash out the supporting structures and achieve flexibility in one washing operation, saving time and avoiding human error with cleaning the model. We evaluated 6 models for MAPCAS surgical planning study. This approach is also cost-effective – an average cost of materials for print is less than $15; models are printed in facility without any delays. Flexibility of 3D printed models approximate soft tissues properly, mimicking Aortopulmonary collateral arteries. Second utilization models has educational value for both residents and patients' family. Simplification of 3D flexible process could help in other models of soft tissue pathologies like aneurysms, ventricular septal defects and other vascular anomalies.