The accuracy of ultrasound-derived three-dimensional printing models for atrial septal defect

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Objective To evaluate the accuracy of three-dimensional printing atrial septal defect (ASD) models from three dimensional transesophageal echocardiography (3D-TEE) images and to lay the foundation for the application of 3D printing technology in the diagnosis and treatment of ASD. Methods Twenty patients with ASD were analyzed retrospectively.2D-TEE and 3D-TEE were performed before ASD occlusion. The 3D-TEE data were post-processed by Mimics software and the volume images of ASD in STL format were developed. Then the STL file was output and the ASD 3D models were printed. The ASD size parameters included the maximal diameter (Dmax), the minimal diameter (Dmin), circumference(C) and area(A), which were measured from 2D-TEE images, 3D-TEE images and 3D printing models, respectively. The absolute difference value of ASD size parameters between 3D printing models and 2D-TEE images, or 3D-TEE images were calculated. The sizes of occluder were recorded during the operation and the preoperative exercises on 3D printing models were performed. Results There were no significant difference in ASD size parameters among 3D printing models, 2D-TEE and 3D-TEE images(all P>0.05), the ASD size parameters were concordant well between 3D printing models and 2D-TEE or 3D-TEE images. Moreover, the absolute difference value of ASD size parameters between 3D printing models and 2D-TEE or 3D-TEE images were little. In addition, linear regression analysis revealed a significant correlation in the Dmax measured from 3D printing models and the sizes of occulder used in the operation (r=0.94, P<0.05). In the ASD 3D printing models the preoperative exercise had an impressive effect. Conclusions It is quite feasible to use 3D-TEE images as the data source of ASD 3D printing models.Ultrasound-derived ASD 3D printing models are of highly accuracy, which have the potential to provide evidence for the clinical application of 3D printing technology. Key words: Echocardiography, transesophageal; Heart septal defect, atrial; 3D printing