Three-dimensional printing of an aortic model for transcatheter aortic valve implantation: possible clinical applications

Excerpt

An 86-year-old male underwent successful TAVI. An Edwards-Sapien XT 23 mm (Edwards Lifesciences, Irvine, CA, USA) prosthesis was selected according to the aortic annulus measure from the echo (21 mm) and the CT Angiography (CTA) scan (17.1 × 26.8 mm). A minimum paravalvular leak (PVL) was detected in the post-procedural echo. The CTA was performed using a 64-slice scanner (Sensation 64, Siemens Medical Solutions; Forchheim. Germany). 3D Slicer (http://​www.​slicer.​org), was used to perform the segmentation and 3D reconstruction of the CTA. An Edwards-Sapien XT prosthesis library was created using SolidWorks (Solidworks Corp. Concord, MA, USA). Finally, a Witbox-2 3D printer (bq, Madrid, Spain) was used to print both the prosthesis library and the 3D model of the aortic root. An interventional cardiologist, who was unaware of the procedural details, was asked to select the prosthesis he would have implanted in the patient by visually inspecting the printed models of the aortic root and the different prosthesis sizes. He chose the 23 mm size—which was indeed the one that was implanted—evaluating as well how the prosthesis relation to the valvular plane and to the origin of the coronary arteries (Fig. 1). …