A b s t r a c t Background and aim:To evaluate the accuracy of the three-dimensional (3D) printing of cardiovascular structures. To explore whether utilisation of 3D printed heart replicas can improve surgical and catheter interventional planning in patients with complex congenital heart defects. Methods:Between December 2014 and November 2015 we fabricated eight cardiovascular models based on computed tomography data in patients with complex spatial anatomical relationships of cardiovascular structures. A Bland-Altman analysis was used to assess the accuracy of 3D printing by comparing dimension measurements at analogous anatomical locations between the printed models and digital imagery data, as well as between printed models and in vivo surgical findings. The contribution of 3D printed heart models for perioperative planning improvement was evaluated in the four most representative patients. Results:Bland-Altman analysis confirmed the high accuracy of 3D cardiovascular printing. Each printed model offered an improved spatial anatomical orientation of cardiovascular structures.Conclusions: Current 3D printers can produce authentic copies of patients` cardiovascular systems from computed tomography data. The use of 3D printed models can facilitate surgical or catheter interventional procedures in patients with complex congenital heart defects due to better preoperative planning and intraoperative orientation.

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AIM: Asymptomatic atrial fi brillation (AF) detection and pulmonary veins isolation (PVI) outcome prediction remain challenging. Our aim was to study the association between apelin and paroxysmal AF in patients undergoing radiofrequency catheter PVI. METHODS: Sixty-three consecutive patients (55 ± 8years, 12 females) with paroxysmal AF without a structural heart disease and implanted ECG loop recorders undergoing PVI and healthy control group of 34 persons (41 ± 9.5years, 21 females) were included. Apelin plasmatic concentrations were measured before and three months after PVI. AF burden was continually assessed for three years. RESULTS: Apelin was signifi cantly decreased in AF patients compared to the healthy controls (0.79 ± 0.09 vs 0.98 ± 0.06 ng/ml; p < 0.00001). Apelin plasmatic concentration of 0.89 ng/ml had 94 % specifi city and 89 % sensitivity for AF prediction with the area under the curve (AUC) of 0.96. After propensity matching to sex, age and comorbidities, apelin concentration was signifi cantly lower in AF group (0.78 ± 0.1 vs 0.99 ± 0.06 ng/ml; p < 0.0001; AUC: 0.97). There was a signifi cant inverse correlation between apelin concentration and AF burden both before and after PVI (Rho =-0.22; p = 0.05) and (Rho =-0.51; p = 0.006), respecti vely. There was no signifi cant association between pre-PVI apelin and PVI long-term outcome. CONCLUSION: In patients without a structural heart disease apelin showed a signifi cant specifi city and sensitivity for AF prediction and inversely correlated with AF burden (Tab.

OBJECTIVES: To present our experience with initial fabrication of 3D printed model of heart from cardiac magnetic resonance (CMR) imaging data. METHODS: A 20-year-old patient with a congenital heart defect after a surgical correction underwent CMR imaging. A novel whole-heart CMR imaging sequence, not requiring gadolinium contrast material application, was performed. Image data from this CMR sequence were used for 3D heart model printing. RESULTS: A lifelike 3D printed copy of the heart with a congenital defect with superior visualization of cardiovascular anatomical details was successfully fabricated. CONCLUSION: 3D printing of the heart copies from novel whole heart CMR imaging data is feasible and harmless to patients. These models can be used for operative planning of complex congenital heart defects (Fig. 4, Ref. 14).