Three‐dimensional printing in congenital heart disease: A systematic review

Abstract

Three‐dimensional (3D) printing has shown great promise in medicine with increasing reports in congenital heart disease (CHD). This systematic review aims to analyse the main clinical applications and accuracy of 3D printing in CHD, as well as to provide an overview of the software tools, time and costs associated with the generation of 3D printed heart models. A search of different databases was conducted to identify studies investigating the application of 3D printing in CHD. Studies based on patient's medical imaging datasets were included for analysis, while reports on in vitro phantom or review articles were excluded from the analysis. A total of 28 studies met selection criteria for inclusion in the review. More than half of the studies were based on isolated case reports with inclusion of 1–12 cases (61%), while 10 studies (36%) focused on the survey of opinion on the usefulness of 3D printing by healthcare professionals, patients, parents of patients and medical students, and the remaining one involved a multicentre study about the clinical value of 3D printed models in surgical planning of CHD. The analysis shows that patient‐specific 3D printed models accurately replicate complex cardiac anatomy, improve understanding and knowledge about congenital heart diseases and demonstrate value in preoperative planning and simulation of cardiac or interventional procedures, assist surgical decision‐making and intra‐operative orientation, and improve patient‐doctor communication and medical education. The cost of 3D printing ranges from USD 55 to USD 810. This systematic review shows the usefulness of 3D printed models in congenital heart disease with applications ranging from accurate replication of complex cardiac anatomy and pathology to medical education, preoperative planning and simulation. The additional cost and time required to manufacture the 3D printed models represent the limitations which need to be addressed in future studies.

A systematic review of clinical value of three-dimensional printing in renal disease

“…A systematic review of 48 studies has summarised the findings of using 3D printed models in cardiovascular and cerebrovascular diseases, with high accuracy of 3D printing in reproducing complex cardiac anatomy and pathologies, and usefulness in both education and surgical planning (8). Another recent systematic review of 28 studies focuses on the 3D printing in congenital heart disease (10). Through analysis of case reports and original studies the review further confirms the clinical value of patient-specific 3D printed heart models in preoperative planning and simulation of congenital heart disease treatment and improving medical education and doctor-patient communication.…”

“…Image postprocessing and segmentation of medical imaging data could be time-consuming, especially when dealing with 3D printed heart or liver models due to complex structures in these regions. Further, a number of editing processes are applied to ensure successful 3D printing outcomes (10). For 3D printed heart and liver models, the time spent on image processing and segmentation could be up to 12 and 15 hours respectively, according to the systematic review and other reports (9,10).…”

“…Further, a number of editing processes are applied to ensure successful 3D printing outcomes (10). For 3D printed heart and liver models, the time spent on image processing and segmentation could be up to 12 and 15 hours respectively, according to the systematic review and other reports (9,10). The whole process of creating a 3D printed liver model could be up to 100 hours, and this does not take into account post-printing work, which could take up to 4-5 days as reported in some studies (37)(38)(39).…”

“…Three-dimensional (3D) printing has been increasingly used in medicine with reports showing great promise in many areas ranging from applications in orthopaedics and maxillofacial reconstruction to cardiovascular and liver diseases (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Patient-specific 3D printed models based on computed tomography (CT) or magnetic resonance imaging (MRI) data have been shown to accurately replicate complex anatomical structures and pathologies when compared to original source images (2)(3)(4)7).…”

“…Patient-specific 3D printed models based on computed tomography (CT) or magnetic resonance imaging (MRI) data have been shown to accurately replicate complex anatomical structures and pathologies when compared to original source images (2)(3)(4)7). 3D printed models can also be used to assist pre-surgical planning and simulation, improve understanding of anatomy and individual lesions (8)(9)(10).…”