3D Printing for Cardiovascular Applications: From End-to-End Processes to Emerging Developments

Abstract

Abstract3D printing as a means of fabrication has seen increasing applications in medicine in the last decade, becoming invaluable for cardiovascular applications. This rapidly developing technology has had a significant impact on cardiovascular research, its clinical translation and education. It has expanded our understanding of the cardiovascular system resulting in better devices, tools and consequently improved patient outcomes. This review discusses the latest developments and future directions of generating medical replicas (‘phantoms’) for use in the cardiovascular field, detailing the end-to-end process from medical imaging to capture structures of interest, to production and use of 3D printed models. We provide comparisons of available imaging modalities and overview of segmentation and post-processing techniques to process images for printing, detailed exploration of latest 3D printing methods and materials, and a comprehensive, up-to-date review of milestone applications and their impact within the cardiovascular domain across research, clinical use and education. We then provide an in-depth exploration of future technologies and innovations around these methods, capturing opportunities and emerging directions across increasingly realistic representations, bioprinting and tissue engineering, and complementary virtual and mixed reality solutions. The next generation of 3D printing techniques allow patient-specific models that are increasingly realistic, replicating properties, anatomy and function.

Algorithms used in medical image segmentation for 3D printing and how to understand and quantify their performance

“…Many studies have identified absolute differences in accuracy between programs for specific software, [15,18], described 3D printing workflows for different applications [19][20][21], and discussed printing best practices [22,23]. In this paper, the behaviors of different mathematical algorithms used in ROI segmentation and refinement are reviewed to highlight key features that can affect the transformation of medical images into 3D printable models.…”

Annotated computed tomography coronary angiogram images and associated data of normal and diseased arteries

“…Device manufacturers and researchers with an interest in cardiovascular modelling, prediction and treatment of coronary artery disease can analyse this data directly or combine it with other available datasets. The smooth surface meshes and centrelines can be directly used for computational modelling 16 , directly 3D printed for experiments [18][19][20][21] , assist in developing and testing medical devices such as stents [22][23][24] , and can be used for Virtual Reality applications for education and training [25][26][27] . Moreover, our dataset allows for the development and benchmarking of new segmentation algorithms aiming to efficiently annotate the coronary arteries automatically as per ASOCA challenge 28 .…”

Fabrication of Soft Transparent Patient‐Specific Vascular Models with Stereolithographic 3D printing and Thiol‐Based Photopolymerizable Coatings

“…[41] Stereolithography, or SLA, as the oldest additive manufacturing (AM) technology, can be a costeffective option as it can achieve a relatively high resolution and a smoother surface finish as compared to cheaper alternatives like FDM. [43,44] Despite the superior surface quality that can be achieved with SLA 3D printing, it is not easy to avoid a certain level of surface roughness associated with the inherent layering process. [45][46][47] This is commonly referred to as the "stairstepping" effect and can hinder the optical transparency of 3Dprinted objects created from allegedly clear and transparent VAT resins.…”