Three dimensional modeling of atrioventricular valves provides predictive guides for optimal choice of prosthesis

Abstract

Inaccuracies in intraoperative and preoperative measurements and estimations may lead to adverse outcomes such as patient-prosthesis mismatch. We aim to measure the relation between different dimensions of the atrioventricular valve complex in explanted porcine heart models. After a detailed physical morphology study, a cast of the explanted heart models was made using silicon-based materials. Digital models were obtained from three-dimensional scanning of the casts, showing the measured annulopapillary distance was 2.50 ± 0.18 cm, and 2.75 ± 0.36 cm for anterior and posterior papillary muscles of left ventricle, respectively. There was a significant linear association between the mitral annular circumference to anterior–posterior distance (p = 0.003, 95% CI 0.78–3.06), mitral annular circumference to interpapillary distance (p = 0.009, 95% CI 0.38–2.20), anterior–posterior distance to interpapillary distance (p = 0.02, 95% CI 0.10–0.78). Anterior–posterior distance appeared to be the most important predictor of mitral annular circumference compared to other measured distances. The mean length of the perpendicular distance of the tricuspid annulus, a, was 2.65 ± 0.54 cm; b was 1.77 ± 0.60 cm, and c was 3.06 ± 0.55 cm. Distance c was the most significant predictor for tricuspid annular circumference (p = 0.006, 95% CI 0.28–2.84). The anterior–posterior distance measured by three-dimensional scanning can safely be used to predict the annular circumference of the mitral valve. For the tricuspid valve, the strongest predictor for the circumference is the c-distance. Other measurements made from the positively correlated parameters may be extrapolated to their respective correlated parameters. They can aid surgeons in selecting the optimal prosthesis for the patients and improve procedural planning.

A Systematic Review of Individualized Heart Surgery with a Personalized Prosthesis

“…Notably, none of these devices were created using 3D bioprinting techniques. This exclusion can be attributed to the inherent limitations and challenges associated with 3D bioprinting in the context of cardiac tissues [42,43]. Postoperative verification of the precision of the surgical prostheses was routinely carried out, primarily relying on computed tomography (CT) scans and echocardiography as the standard modalities for these assessments.…”

On the Use of New 3D Modelization, Reconstruction and Printing Techniques to Improve the Metatarsophalangeal Cancerous Lesion Management

“…It provides a versatile set of tools for creating 3D models using various techniques like polygonal modeling, sculpting, and procedural modeling. Artists and designers can shape and manipulate objects with precision and creativity [17].…”