Dynamic Patient-Specific Three-Dimensional Simulation of Mitral Repair: Can We Practice Mitral Repair Preoperatively?

Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery
Olivia K GintyMichael W A Chu

Abstract

Planned mitral repair strategies are generally established from preoperative echocardiography; however, specific details of the repair are often determined intraoperatively. We propose that three-dimensional printed, patient-specific, dynamic mitral valve models may help surgeons plan and trial all the details of a specific patient's mitral repair preoperatively. Using preoperative echocardiography, segmentation, modeling software, and three-dimensional printing, we created dynamic, high-fidelity, patient-specific mitral valve models including the subvalvular apparatus. We assessed the accuracy of 10 patient mitral valve models anatomically and functionally in a heart phantom simulator, both objectively by blinded echocardiographic assessment, and subjectively by two mitral repair experts. After this, we attempted model mitral repair and compared the outcomes with postoperative echocardiography. Model measurements were accurate when compared with patients on anterior-posterior diameter, circumference, and anterior leaflet length; however, less accurate on posterior leaflet length. On subjective assessment, Likert scores were high at 3.8 ± 0.4 and 3.4 ± 0.7, suggesting good fidelity of the dynamic model echocardiogram and functi...Continue Reading

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Citations

May 23, 2019·International Journal of Computer Assisted Radiology and Surgery·Olivia K GintyTerry M Peters

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