Temperature analysis of 3D-printed biomaterials during unipolar and bipolar radiofrequency ablation procedure

Cappello, Ida Anna; Candelari, Mara; Pannone, Luigi; Monaco, Cinzia; Bori, Edoardo; Talevi, Giacomo; Ramak, Robbert; Meir, Mark La; Gharaviri, Ali; Chierchia, Gian Battista; Innocenti, Bernardo; Asmundis, Carlo de

doi:10.3389/fcvm.2022.978333

Cited by 5 publications

(8 citation statements)

References 8 publications

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“…The PMS were characterized by 10.0 mm of thickness, mimicking the cardiac tissue; indeed, given that the surgical guide is designed for ventricles, the PMS thickness is similar to the wall of a standard human ventricle. Moreover, two different thicknesses (1.0 and 2.5 mm) were analyzed, because thickness and material morphology influence mechanical properties [13].…”

Section: Discussionmentioning

confidence: 99%

“…The experimental test workflow is already explained in detail in our previous study on radiofrequency ablation simulation [13], Figure 1. The previous study discusses mechanical and geometrical changes in MED625FLX and TPU95A in response to radiofrequency ablation.…”

Section: Experimental Testmentioning

confidence: 99%

“…However, because there are no data on their response to cryoenergy delivery during epicardial cryo-treatment using these materials, this study aims at evaluating thermal properties and mechanical and geometrical alterations of MED625FLX and TPU95A during cryoablation simulation. Thermal evaluation of biocompatible materials has been performed only in response to radiofrequency [13] and there are no data on the effect of cryoenergy. However, thermal energy might be associated with damage of epicardial structures such as coronary arteries.…”

Section: Introductionmentioning

confidence: 99%

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3D-Printed Biomaterial Testing in Response to Cryoablation: Implications for Surgical Ventricular Tachycardia Ablation

Candelari

Cappello

Pannone

et al. 2023

JCM

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Background: The lack of thermally and mechanically performant biomaterials represents the major limit for 3D-printed surgical guides, aimed at facilitating complex surgery and ablations. Methods: Cryosurgery is a treatment for cardiac arrhythmias. It consists of obtaining cryolesions, by freezing the target tissue, resulting in selective and irreversible damage. MED625FLX and TPU95A are two biocompatible materials for surgical guides; however, there are no data on their response to cryoenergy delivery. The study purpose is to evaluate the biomaterials’ thermal properties, examining the temperature changes on the porcine muscle samples (PMS) when the biomaterials are in place during the cryoablation. Two biomaterials were selected, MED625FLX and TPU95A, with two thicknesses (1.0 and 2.5 mm). To analyze the biomaterials’ behavior, the PMS temperatures were measured during cryoablation, firstly without biomaterials (control) and after with the biomaterials in place. To verify the biomaterials’ suitability, the temperatures under the biomaterial samples should not exceed a limit of −30.0 °C. Furthermore, the biomaterials’ geometry after cryoablation was evaluated using the grid paper test. Results: TPU95A (1.0 and 2.5 mm) successfully passed all tests, making this material suitable for cryoablation treatment. MED625FLX of 1.0 mm did not retain its shape, losing its function according to the grid paper test. Further, MED625FLX of 2.5 mm is also suitable for use with a cryoenergy source. Conclusions: TPU95A (1.0 and 2.5 mm) and MED625FLX of 2.5 mm could be used in the design of surgical guides for cryoablation treatment, because of their mechanical, geometrical, and thermal properties. The positive results from the thermal tests on these materials and their thickness prompt further clinical investigation.

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Section: Discussionmentioning

confidence: 99%

Section: Experimental Testmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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3D-Printed Biomaterial Testing in Response to Cryoablation: Implications for Surgical Ventricular Tachycardia Ablation

Candelari

Cappello

Pannone

et al. 2023

JCM

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“…Finally, further tests to evaluate the response of materials to ablation energy sources are awaited. In particular, both materials have been recently tested by our group with radiofrequency catheter ablation (11). For surgical guides design, the 2.5mm MED625FLX could be used, with bipolar radiofrequency catheter, ensuring good geometrical, mechanical, and thermal properties.…”

Section: Discussionmentioning

confidence: 99%

A 3D-printed surgical guide for ischemic scar targeting and ablation

Candelari¹,

Cappello²,

Pannone³

et al. 2022

Front. Cardiovasc. Med.

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Background3D printing technology development in medical fields allows to create 3D models to assist preoperative planning and support surgical procedures. Cardiac ischemic scar is clinically associated with malignant arrhythmias. Catheter ablation is aimed at eliminating the arrhythmogenic tissue until the sinus rhythm is restored. The scope of this work is to describe the workflow for a 3D surgical guide able to define the ischemic scar and target catheter ablation.Materials and methodsFor the patient-specific 3D surgical guide and 3D heart phantom model realization, both CT scan and cardiac MRI images were processed; this was necessary to extract anatomical structures and pathological information, respectively. Medical images were uploaded and processed in 3D Slicer. For the surgical guide modeling, images from CT scan and MRI were loaded in Meshmixer and merged. For the heart phantom realization, only the CT segmentation was loaded in Meshmixer. The surgical guide was printed in MED625FLX with Polyjet technology. The heart phantom was printed in polylactide with FDM technology.Results3D-printed surgical model was in agreement with prespecified imputed measurements. The phantom fitting test showed high accuracy of the 3D surgical tool compared with the patient-specific reproduced heart. Anatomical references in the surgical guide ensured good stability. Ablation catheter fitting test showed high suitability of the guide for different ablation tools.ConclusionA 3D-printed guide for ventricular tachycardia ablation is feasible and accurate in terms of measurements, stability, and geometrical structure. Concerning clinical use, further clinical investigations are eagerly awaited.

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“…For the hereby presented 3D model MED625FLX and TPU95A were chosen because of previous literature evaluating the effect of radiofrequency energy sources. In particular both materials have been recently tested by our group with radiofrequency catheter ablation ( 19 ). For surgical guides design, the 2.5 mm MED625FLX could be used, with bipolar radiofrequency catheter, ensuring good geometrical, mechanical and thermal properties.…”

Section: Discussionmentioning

confidence: 99%

Development of a 3D printed surgical guide for Brugada syndrome substrate ablation

Talevi

Pannone

Monaco

et al. 2022

Front. Cardiovasc. Med.

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BackgroundBrugada syndrome (BrS) is a disease associated with ventricular arrhythmias and sudden cardiac death. Epicardial ablation has demonstrated high therapeutic efficacy in preventing ventricular arrhythmias. The purpose of this research is to define a workflow to create a patient-specific 3D-printed tool to be used as a surgical guide for epicardial ablation in BrS.MethodsDue to their mechanical properties and biocompatibility, the MED625FLX and TPU95A were used for cardiac 3D surgical guide printing. ECG imaging was used to define the target region on the right ventricular outflow tract (RVOT). CT scan imaging was used to design the model based on patient anatomy. A 3D patient-specific heart phantom was also printed for fitting test. Sterilization test was finally performed.Results3D printed surgical models with both TPU95A and MED625FLX models were in agreement with pre-specified imputed measurements. The phantom test showed retention of shape and correct fitting of the surgical tool to the reproduced phantom anatomy, as expected, for both materials. The surgical guide adapted to both the RVOT and the left anterior descending artery. Two of the 3D models produced in MED265FLX showed damage due to the sterilization process.ConclusionsA 3D printed patient-specific surgical guide for epicardial substrate ablation in BrS is feasible if a specific workflow is followed. The design of the 3D surgical guide ensures proper fitting on the heart phantom with good stability. Further investigations for clinical use are eagerly awaited.

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Temperature analysis of 3D-printed biomaterials during unipolar and bipolar radiofrequency ablation procedure

Cited by 5 publications

References 8 publications

3D-Printed Biomaterial Testing in Response to Cryoablation: Implications for Surgical Ventricular Tachycardia Ablation

3D-Printed Biomaterial Testing in Response to Cryoablation: Implications for Surgical Ventricular Tachycardia Ablation

A 3D-printed surgical guide for ischemic scar targeting and ablation

Development of a 3D printed surgical guide for Brugada syndrome substrate ablation

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