Utility of 3D printed cardiac models in congenital heart disease: a scoping review

Abstract

ObjectiveThree-dimensional printing (3DP) is a novel technology with applications in healthcare, particularly for congenital heart disease (CHD). We sought to explore the spectrum of use of 3D printed CHD models (3D-CM) and identify knowledge gaps within the published body of literature to guide future research.MethodsWe conducted a scoping review targeting published literature on the use of 3D-CMs. The databases of MEDLINE, EMBASE and Web of Science were searched from their inception until 19 July 2019. Inclusion criteria were primary research; studies reporting use of 3D-CMs; and human subjects. Exclusion criteria were studies where 3D-CMs were generated for proof of concept but not used; and studies focused on bioprinting or computational 3D-CMs. Studies were assessed for inclusion and data were extracted from eligible articles in duplicate.ResultsThe search returned 648 results. Following assessment, 79 articles were included in the final qualitative synthesis. The majority (66%) of studies are case reports or series. 15% reported use of a control group. Three main areas of utilisation are for (1) surgical and interventional cardiology procedural planning (n=62), (2) simulation (n=25), and (3) education for medical personnel or patients and their families (n=17). Multiple studies used 3D-CMs for more than one of these areas.Conclusions3DP for CHD is a new technology with an evolving literature base. Most of the published literature are experiential reports as opposed to manuscripts on scientifically robust studies. Our study has identified gaps in the literature and addressed priority areas for future research.

Quantitative Assessment of 3D Printed Model Accuracy in Delineating Congenital Heart Disease

“…It can also demonstrate the complexity of the intra-cardiac structures and changes in the treatment plans. However, the model accuracy was not discussed [31].…”

Clinical Applications of Patient-Specific 3D Printed Models in Cardiovascular Disease: Current Status and Future Directions

“…Promising results of 3D printing in the cardiovascular applications are shown in the above-mentioned areas, however, a number of limitations exist which still hinder the widespread use of 3D printing in clinical practice. Prospective and multi-centre studies are still lacking with RCTs only available in the 3D printing in CHD for medical education, while in other areas, case reports or case series dominate most of the applications (66%) as shown in a recent review article on 3D printing in CHD [118]. Inclusion of a larger sample size with potential longitudinal studies of mid to long-term outcomes is necessary to validate the clinical value of 3D printing such as how 3D printed models change patient's management and whether treatment outcomes are significantly improved with incorporation of 3D printing into practice.…”

Comparative Effectiveness of Virtual Reality (VR) vs 3D Printed Models of Congenital Heart Disease in Resident and Nurse Practitioner Educational Experience

“…Given the close relationship between spatial orientation and physiology that characterizes Pediatric Cardiology, there is a pedagogical imperative to develop approaches that make elds such as congenital heart disease more visually accessible. 3DP and VR have arisen as potential tools in this effort and the preponderance of evidence to date suggests bene ts in regard to learner engagement (1,3,(10)(11)(12). Less robust evidence exists to compare the relative value of these modalities.…”

“…By asking both subjective questions as well as fact based and spatial conceptualization questions in the post-test, this study was able to demonstrate improvement in knowledge acquisition more rigorously. In regard to 3DP, a recent review highlights the need to systematically examine if there are certain groups who may bene t more from such modalities (3).…”

“…3DP has found multiple applications in pediatric cardiology education. Several studies have incorporated 3DP into curricula to compare learner response compared to traditional teaching modalities (1,(3)(4)(5).…”