Mitral Valve-in-Valve Implant of a Balloon-Expandable Valve Guided by 3-Dimensional Printing

Abstract

BackgroundOur goal was to explore the role of 3-dimensional (3D) printing in facilitating the outcome of a mitral valve-in-valve (V-in-V) implant of a balloon-expandable valve.MethodsFrom November 2020 to April 2021, 6 patients with degenerated mitral valves were treated by a transcatheter mitral V-in-V implant of a balloon-expandable valve. 3D printed mitral valve pre- and post-procedure models were prepared to facilitate the process by making individualized plans and evaluating the outcomes.ResultsEach of the 6 patients was successfully implanted with a balloon-expandable valve. From post-procedural images and the 3D printed models, we could clearly observe the valve at the ideal position, with the proper shape and no regurgitation. 3D printed mitral valve models contributed to precise decisions, the avoidance of complications, and the valuation of outcomes.Conclusions3D printing plays an important role in guiding the transcatheter mitral V-in-V implant of a balloon-expandable valve.Clinical Trial RegistrationClinicalTrials.gov Protocol Registration System (NCT02917980).

Transapical Mitral Valve-in-Ring Replacement Using the Innovative System under 3-Dimensional Printing Guidance

“…This method offers a valuable solution to address the limitations of evaluating complex MV, enabling a more comprehensive and precise assessment of anatomical structures. Additionally, 3D printing can guide device selection and evaluate device–bioprosthesis interactions and potential complications [ 7 , 8 , 9 ]. Mao et al [ 8 ] utilized 3D printing to restore the patient’s degenerative mitral bioprosthetic structure, facilitating evaluation and simulation prior to the valve-in-valve procedure.…”

“…Additionally, 3D printing can guide device selection and evaluate device–bioprosthesis interactions and potential complications [ 7 , 8 , 9 ]. Mao et al [ 8 ] utilized 3D printing to restore the patient’s degenerative mitral bioprosthetic structure, facilitating evaluation and simulation prior to the valve-in-valve procedure. This approach allowed for accurate selection of the appropriate size of the balloon-expandable valve and ensured optimal device positioning, resulting in satisfactory clinical outcomes.…”

“…We present a case of a patient who underwent TMViR. A patient-specific, 3D-printed model was utilized to gain valuable insights into the shape of the landing zone, facilitating discussions regarding valve sizing and determining the optimal position for the valve-in-ring procedure [ 6 , 7 , 8 , 9 , 10 ]. Moreover, the model enabled simulation of the main procedural steps and prediction of potential intraoperative complications, and the utilization of 3D printing technology allows us to thoroughly explore the unique properties of new devices and significantly reduces the learning curve associated with their implementation.…”

“…In recent years, the application of cardiovascular 3-dimensional (3D) printing technology has proven to be highly beneficial in facilitating precise preprocedural assessment and guidance for structural heart interventions [ 6 , 7 , 8 , 9 , 10 ]. We present the first case report of a transcatheter mitral valve-in-ring replacement (TMViR) procedure utilizing the innovative Mi-thos system (NewMed Medical Co., Ltd., Shanghai, China) via the transapical approach.…”

Transcatheter Mitral Valve-in-Valve Replacement Guided by 3-Dimensional Printing to Treat Patient Who Successively Underwent Mitral Valve Replacement, Tricuspid Valvuloplasty, and Transcatheter Aortic Valve Replacement

“…With the continuous development of cardiovascular 3D printing technology, surgeons can use 3D printed models to perform simulated evaluation before the procedures, which plays an important role in assisting and guiding the accurate formulation of a surgical plan and improving the success rate of the procedures [11]. Before performing the procedures, the CT data of the specific patient were evaluated in detail, and the 3D reconstruction and 3D model printing were performed using the CT data.…”